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Use of Antidepressants among Patients Diagnosed with Depression: A Scoping Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6699028. [PMID: 33791379 PMCID: PMC7984896 DOI: 10.1155/2021/6699028] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 01/11/2023]
Abstract
Introduction Depression is a major global health problem with a relatively high lifetime prevalence and significant disability. Antidepressants are the most effective medications used for the treatment of depression. Hence, this study is aimed at summarizing the studies on antidepressant use among patients diagnosed with depression. Method PubMed, Embase, Web of Science, Scopus, and Google Scholar were searched for literature (2000-2019) using keywords such as depression, drug utilization, antidepressants, prescription, serotonin reuptake inhibitor, serotonin and norepinephrine reuptake inhibitor, tricyclic antidepressants, and atypical antidepressants. Results Antidepressant users were mostly females, married people, housewives, lower-income people, employees, and highly educated people, as they were found to be more prone to develop depression than their counterparts. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, were most commonly prescribed among depressive patients. Conclusion Our study suggested that out of five major antidepressant drugs available for the treatment of depression, selective serotonin reuptake inhibitors are preferred over others because of their better side effects and tolerability profile.
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Kim MJ, Kim N, Shin D, Rhee SJ, Park CHK, Kim H, Cho SJ, Lee JW, Kim EY, Yang B, Ahn YM. The epidemiology of antidepressant use in South Korea: Does short-term antidepressant use affect the relapse and recurrence of depressive episodes? PLoS One 2019; 14:e0222791. [PMID: 31553786 PMCID: PMC6760791 DOI: 10.1371/journal.pone.0222791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/06/2019] [Indexed: 02/01/2023] Open
Abstract
Background The duration of antidepressant use affects the treatment of depression. Using the National Health Insurance database, which covers almost the entire national population, we verified the factors associated with the inadequate short-term use of initially prescribed antidepressants and their effects on the relapse and recurrence of depressive episodes. Methods There were 752,190 patients included who had been newly prescribed antidepressants in 2012 with the diagnosis of depressive disorder. They were followed-up until December 31, 2015. They were classified as short-term and long-term antidepressant users depending on whether they used a specific initial antidepressant for at least four weeks. Sociodemographic, clinical, and medical utilization factors affecting the duration of antidepressant use were investigated. We also identified whether the duration of antidepressant use affected the risk of relapse and recurrence, which was defined by the restarting of antidepressants. Results Initial antidepressants were taken for less than 28 days by 458,057 (60.84%) patients. Tricyclic antidepressants were used as the initial antidepressant more frequently than selective serotonin reuptake inhibitors (64.5% versus 19.3%). The type of initial antidepressant, polypharmacy, psychiatric and medical comorbidities, type of insurance coverage, and type of medical institution visited were associated with short-term use. Short-term use marginally increased the risk of relapse and recurrence of depressive episodes (Hazard ratio: 1.06, 95% confidence intervals 1.048–1.075). Conclusions Short-term antidepressant use is widespread in Korea, and assessment in various aspects are necessary to set proper treatment plans.
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Affiliation(s)
- Min Ji Kim
- Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Namwoo Kim
- Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Daun Shin
- Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Sang Jin Rhee
- Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - C. Hyung Keun Park
- Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
- Department of Psychiatry and Behavioral Science, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Hyeyoung Kim
- Department of Psychiatry, Inha University Hospital, Inhang-ro, Jung-gu, Incheon, Republic of Korea
| | - Sung Joon Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Won Lee
- Dept. of Psychiatry Seoul Metropolitan Eunpyeong Hospital, dept. of Psychiatry, Eunpyeong-gu, Seoul, Republic of Korea
| | - Eun Young Kim
- Mental Health Center, Seoul National University Health Care Center, Gwanak-gu, Seoul, Republic of Korea
- Department of Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Boram Yang
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South-Korea
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
- Department of Psychiatry and Behavioral Science, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
- * E-mail:
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Antidepressants-related cardiovascular adverse events using the adverse event reporting system. Psychiatry Res 2018; 268:441-446. [PMID: 30130711 DOI: 10.1016/j.psychres.2018.07.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 01/17/2023]
Abstract
The aim of this study was to evaluate clinical manifestations and the age and sex distribution of cardiovascular adverse events (CVAEs) related to antidepressants. The FDA Adverse Event Reporting System (FAERS) and Korea Adverse Event Reporting System (KAERS) database records on patients prescribed antidepressants were used. The frequency of CVAEs was compared between adults (19-64 years) and an older (age ≥ 65 years) group. In total, 75,608 CVAEs from 43,824 patients and 325 CVAEs from 313 patients in FAERS and KAERS, respectively, were included in the analysis. Among them, 7066 (16.08%) and 103 (32.91%) patients were 65 years of age or older in FAERS and KAERS, respectively. Serious AEs were significantly more common among older patients compared to adults in both the FAERS and KAERS datasets. CVAEs were frequently reported with paroxetine and duloxetine in the FAERS, while amitriptyline and duloxetine were reported in the KAERS. The two most frequent CVAEs were "ventricular arrhythmias and cardiac arrest" and "rate and rhythm disorders" in the FAERS, while "hypotension", and "oedema", were found in the KAERS. Several CVAEs were detected by the reporting odds ratios and proportional reporting ratios methods. The serious AEs associated with antidepressants might have a significant impact on older patients.
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Kim J, Kim Y. Which Patients Are Prescribed Escitalopram?: Predictors for Escitalopram Prescriptions and Functional Outcomes among Patients with Acute Ischemic Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061085. [PMID: 29843379 PMCID: PMC6025022 DOI: 10.3390/ijerph15061085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/21/2018] [Accepted: 05/25/2018] [Indexed: 01/30/2023]
Abstract
Recent studies have demonstrated that antidepressants could enhance functional recovery via neuroplasticity beyond solely treating depression. However, since Koreans typically show a greater aversion to seeking psychiatric care than citizens of Western countries, the number of antidepressant prescriptions is low. Through this study, we aim to identify the factors that lead to the prescription of antidepressants in subjects with acute ischemic stroke (AIS) in clinical practice. A total of 775 patients with ischemic stroke (IS) participated in this study from March 2010 to May 2013. We used binary logistic regression to find predictors for escitalopram prescriptions. To reveal predictors for short-term functional outcomes, we used an adjusted regression model using a propensity score. Among the 775 participants, 39 (5.03%) were prescribed escitalopram. The duration of hospital stay (odds ratio (OR) = 1.07; 95% confidence interval (CI) = 1.04–1.10) and the use of mechanical ventilation were significantly more closely related to escitalopram prescriptions as compared to non-escitalopram prescriptions (OR = 5.15; 95% CI = 1.53–17.40). The use of escitalopram, on the other hand, was not significantly associated with short-term functional outcomes (OR = 1.27; 95% CI = 0.50–3.25). Duration of hospital stay and use of mechanical ventilation were significantly related to escitalopram prescriptions.
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Affiliation(s)
- Jarim Kim
- School of Communication, Kookmin University, Bugak Hall 603, 77 Jeongneung-ro, Seongbuk-gu, Seoul 02707, Korea.
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 05355, Korea.
- College of Medicine, Seoul National University, Seoul 03080, Korea.
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Park SC, Jang EY, Kim JM, Jun TY, Lee MS, Kim JB, Yim HW, Park YC. Clinical Validation of the Psychotic Depression Assessment Scale, Hamilton Depression Rating Scale-6, and Brief Psychiatric Rating Scale-5: Results from the Clinical Research Center for Depression Study. Psychiatry Investig 2017; 14:568-576. [PMID: 29042881 PMCID: PMC5639124 DOI: 10.4306/pi.2017.14.5.568] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/26/2016] [Accepted: 08/15/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to validate the psychotic depression assessment scale (PDAS), which includes the six-item melancholia subscale from the Hamilton depression rating scale (HAMD-6) and the five-item psychosis subscale from the brief psychiatric rating scale (BPRS-5). Data from the Clinical Research Center for Depression (CRESCEND) study, which is a 52-week naturalistic trial, were analyzed. METHODS Fifty-two patients with psychotic depression from the CRESCEND study met our inclusion criteria. The patients underwent the following psychometric assessments: the PDAS, including HAMD-6 and BPRS-5, the clinical global impression scales, the HAMD, the positive symptom subscale, and the negative symptom subscale. Assessments were performed at the baseline and then at weeks 1, 2, 4, 8, 12, 24, and 52. Spearman correlation analyses were used to assess the clinical validity and responsiveness of the PDAS. RESULTS The clinical validity and responsiveness of the PDAS, including HAMD-6 and BPRS-5, were acceptable, with the exception of the clinical responsiveness of the PDAS for positive symptoms and the clinical responsiveness of BPRS-5 for negative symptoms. CONCLUSION The clinical relevance of the PDAS has been confirmed and this clinical validation will enhance its clinical utility and availability.
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Affiliation(s)
- Seon-Cheol Park
- Department of Psychiatry, Inje University College of Medicine and Haeundae Paik Hospital, Busan, Republic of Korea
| | - Eun Young Jang
- Department of Counseling Psychology, Honam University College of Humanities and Social Sciences, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University School of Medicine, Gwangju, Republic of Korea
| | - Tae-Youn Jun
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Min-Soo Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jung-Bum Kim
- Department of Psychiatry, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Hyeon-Woo Yim
- Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Yong Chon Park
- Department of Psychiatry, Hanyang University, Guri Hospital, Guri, Republic of Korea
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Jung WY, Jang SH, Kim SG, Jae YM, Kong BG, Kim HC, Choe BM, Kim JG, Kim CR. Times to Discontinue Antidepressants Over 6 Months in Patients with Major Depressive Disorder. Psychiatry Investig 2016; 13:440-6. [PMID: 27482246 PMCID: PMC4965655 DOI: 10.4306/pi.2016.13.4.440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 09/12/2015] [Accepted: 10/24/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of the present study was to investigate differences in discontinuation time among antidepressants and total antidepressant discontinuation rate of patients with depression over a 6 month period in a naturalistic treatment setting. METHODS We reviewed the medical records of 900 patients with major depressive disorder who were initially prescribed only one kind of antidepressant. The prescribed antidepressants and the reasons for discontinuation were surveyed at baseline and every 4 weeks during the 24 week study. We investigated the discontinuation rate and the mean time to discontinuation among six antidepressants groups. RESULTS Mean and median overall discontinuation times were 13.8 and 12 weeks, respectively. Sertraline and escitalopram had longer discontinuation times than that of fluoxetine, and patients who used sertraline discontinued use significantly later than those taking mirtazapine. No differences in discontinuation rate were observed after 24 weeks among these antidepressants. About 73% of patients discontinued antidepressant treatment after 24 weeks. CONCLUSION Sertraline and escitalopram tended to have longer mean times to discontinuation, although no difference in discontinuation rate was detected between antidepressants after 24 weeks. About three-quarters of patients discontinued antidepressant maintenance therapy after 24 weeks.
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Affiliation(s)
- Woo-Young Jung
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Sae-Heon Jang
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea
| | - Sung-Gon Kim
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Psychiatry, Pusan National University College of Medicine, Busan, Republic of Korea
| | - Young-Myo Jae
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea
| | - Bo-Geum Kong
- Department of Psychiatry, Inje University Paik Hospital, Busan, Republic of Korea
| | - Ho-Chan Kim
- Department of Psychiatry, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Byeong-Moo Choe
- Department of Psychiatry, Dong-A University Medical Center, Busan, Republic of Korea
| | - Jeong-Gee Kim
- Department of Psychiatry, Maryknoll Medical Center, Busan, Republic of Korea
| | - Choong-Rak Kim
- Department of Statistics, Pusan National University, Busan, Republic of Korea
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Treuer T, Liu CY, Salazar G, Kongsakon R, Jia F, Habil H, Lee MS, Lowry A, Dueñas H. Use of antidepressants in the treatment of depression in Asia: guidelines, clinical evidence, and experience revisited. Asia Pac Psychiatry 2013; 5:219-30. [PMID: 23857712 DOI: 10.1111/appy.12090] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 05/21/2013] [Indexed: 12/19/2022]
Abstract
Major depressive disorder is prevalent worldwide, and only about half of those affected will experience no further episodes or symptoms. Additionally, depressive symptoms can be challenging to identify, with many patients going undiagnosed despite a wide variety of available treatment options. Antidepressants are the cornerstone of depression treatment; however, a large number of factors must be considered in selecting the treatment best suited to the individual. To help support physicians in this process, international and national treatment guidelines have been developed. This review evaluates the current use of antidepressant treatment for major depressive disorder in six Asian countries (China, Korea, Malaysia, Philippines, Taiwan, and Thailand). No remarkable differences were noted between Asian and international treatment guidelines or among those from within Asia as these are adapted from western guidelines, although there were some local variations. Importantly, a shortage of evidence-based information at a country level is the primary problem in developing guidelines appropriate for Asia, so most of the guidelines are consensus opinions derived from western research data utilized in western guidelines. Treatment guidelines need to evolve from being consensus based to evidence based when evidence is available, taking into consideration cost/effectiveness or cost/benefit with an evidence-based approach that more accurately reflects clinical experience as well as the attributes of each antidepressant. In everyday practice, physicians must tailor their treatment to the patient's clinical needs while considering associated external factors; better tools are needed to help them reach the best possible prescribing decisions which are of maximum benefit to patients.
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Affiliation(s)
- Tamás Treuer
- Neuroscience Research, Eli Lilly and Company, Budapest, Hungary
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