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Antidepressant side effects and physician prescribing patterns

J J Huszonek1, M J Dewan, M Koss

  • 1Department of Psychiatry, SUNY Health Science Center, Syracuse 13210.

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists
|March 1, 1993
PubMed
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Physicians initially did not prioritize antidepressants with fewer side effects. By 1989, psychiatrists shifted towards prescribing safer antidepressants, indicating a positive change in prescribing patterns.

Area of Science:

  • Pharmacology
  • Psychiatry
  • Health Services Research

Background:

  • Physicians' prescribing patterns for antidepressants (ADs) are influenced by various factors, including side effect (SE) profiles.
  • Understanding these patterns is crucial for optimizing patient care and treatment outcomes.

Purpose of the Study:

  • To investigate whether physicians preferentially prescribe ADs with minimal sedation, orthostatic hypotension, and anticholinergic activity.
  • To examine recent changes in AD prescribing patterns.
  • To determine if prescribing patterns differ between psychiatrists and nonpsychiatrists.

Main Methods:

  • Analysis of outpatient prescribing data for specific ADs from the National Prescription Audit (NPA) for 1986 and 1989.
  • Comparison of prescribing trends between psychiatrists and nonpsychiatrists.

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Main Results:

  • In 1986, physicians did not consistently minimize the use of ADs with higher SEs.
  • By 1989, a significant shift was observed, with psychiatrists increasingly prescribing ADs with lower SEs and reducing prescriptions for those with more SEs.
  • Nonpsychiatrists also showed some movement towards prescribing ADs with fewer SEs.

Conclusions:

  • Physician prescribing of antidepressants has evolved, with a notable shift towards agents with fewer side effects, particularly among psychiatrists.
  • The introduction of fluoxetine and increased attention to side effects likely contributed to this change.
  • Further research is needed to fully elucidate the factors driving physicians' AD choices.