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Antidepressant prescribing patterns among VA patients with schizophrenia
Seth Himelhoch1, Eric Slade, Julie Kreyenbuhl
1Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21212, United States. shimelho@psych.umaryland.edu
Schizophrenia Research
|February 14, 2012
Summary
Antidepressants are frequently prescribed for veterans with schizophrenia, often alongside other mental health diagnoses. Further research is needed to understand the reasons for this common practice and its associated risks and benefits.
Area of Science:
- Psychiatry
- Clinical Pharmacy
- Health Services Research
Background:
- Reviews question the effectiveness of antidepressants for depression or negative symptoms in schizophrenia.
- Antidepressant use in schizophrenia patients is a subject of ongoing debate regarding efficacy and necessity.
Purpose of the Study:
- To estimate the prevalence and incidence of antidepressant medication receipt in veterans with schizophrenia.
- To identify demographic, diagnostic, and clinical factors associated with antidepressant use in this population.
Main Methods:
- Retrospective analysis of administrative data from the VA mid-Atlantic region for fiscal year 2007.
- Involved 2412 veterans diagnosed with schizophrenia.
- Multivariable logistic regression was used to assess predictors of antidepressant receipt.
Main Results:
- 37.4% of veterans with schizophrenia received an antidepressant prescription in FY07; 26.7% were new prescriptions.
- Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) were most common.
- Antidepressant use was linked to co-occurring depression, PTSD, anxiety, schizoaffective disorder, and specialty mental health care. Homelessness was associated with lower receipt.
Conclusions:
- Antidepressants are commonly prescribed to veterans with schizophrenia, particularly those with comorbid conditions and receiving specialty mental health care.
- The study highlights the need for further investigation into the rationale behind prescribing antidepressants to this population.
- Future research should weigh the benefits against the potential health risks of antidepressant use in schizophrenia.
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