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Antidepressant prescribing patterns in Australia.

Gin S Malhi1, Mustafa Acar2, Mahsa H Kouhkamari3

  • 1Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, St Leonards, New South Wales, Australia; CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia; and Department of Psychiatry, University of Oxford, Oxford, UK.

Bjpsych Open
|June 30, 2022
PubMed
Summary

Australian antidepressant prescribing generally aligns with guidelines, though variations exist between General Practitioners and psychiatrists. Treatment duration varies by antidepressant class, highlighting the need for personalized care in mood disorder management.

Keywords:
Antidepressantsclinical practice guidelinesdepressive disordersprescribing patternsreal-world evidence

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Area of Science:

  • Pharmacology
  • Psychiatry
  • Public Health

Background:

  • Clinical practice guidelines (MDcpg2015, MDcpg2020) offer evidence-based recommendations for managing mood disorders.
  • These guidelines are developed by the Royal Australian and New Zealand College of Psychiatrists.

Purpose of the Study:

  • To evaluate Australian real-world antidepressant prescribing practices.
  • To determine adherence of clinical management to the MDcpg2015 recommendations.

Main Methods:

  • Retrospective analysis of Australian Pharmaceutical Benefits Scheme (PBS) data.
  • Cohort included patients aged 16 years and older dispensed PBS-listed antidepressants.
  • Data spanned from July 2013 to June 2019.

Main Results:

  • Over 239,000 patients initiated antidepressant treatment between July 2013 and June 2019.
  • Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) were the most common first-line treatments, despite TCAs not being recommended.
  • Median treatment duration was 4.5 months, with SSRIs lasting longer than TCAs.

Conclusions:

  • Initial antidepressant prescribing largely aligns with established guidelines.
  • Prescribing patterns differ between General Practitioners and psychiatrists, suggesting tailored treatment approaches.
  • Future guidelines should address the complexity and varied presentations of depression.