Appropriateness of prescribing practices for serotonergic antidepressants

Data from prescribing physicians were used to assess whether serotonergic antidepressants were used for appropriate indications and at appropriate initial dosages.

Data were derived from the confidential logs of psychiatrists and primary care physicians who provided prescription information from January 1, 1997, through June 30, 1999, as part of the National Disease and Therapeutic Index physician survey. The survey is not affiliated with a reimbursement system and therefore minimizes bias related to reimbursement. Data on the primary reason for use and the dosage at the time of first use were obtained for prescriptions of citalopram, fluoxetine, paroxetine, sertraline, venlafaxine, and extended-release venlafaxine.

Depressive disorders accounted for the majority of the 3,206 prescriptions for the six antidepressants (74 percent to 86.2 percent). The next most common indications for use were anxiety (4.1 percent to 12.6 percent) and obsessive-compulsive disorder (1.3 percent to 3.3 percent). For patients with depressive disorders, psychiatrists prescribed slightly higher antidepressant dosages than primary care physicians.

Serotonergic antidepressants are used primarily for the treatment of depression and depression-related disorders and are prescribed at the recommended starting dosages.