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Antidepressant treatment in general practice--an interview study

J U Rosholm1, L F Gram, N Damsbo

  • 1Department of Clinical Pharmacology, Odense University, Denmark.

Scandinavian Journal of Primary Health Care
|December 1, 1995
PubMed
Summary
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General practitioners often use antidepressants (AD) long-term, with uncertain indications and low doses, diverging from evidence-based guidelines for depression treatment.

Area of Science:

  • Psychiatry and General Practice
  • Pharmacotherapy Research

Background:

  • Antidepressant (AD) use is common in general practice.
  • Understanding the real-world application of ADs is crucial for optimizing patient care.

Purpose of the Study:

  • To identify potential issues associated with antidepressant prescribing in primary care settings.
  • To evaluate the current practices of AD utilization by general practitioners.

Main Methods:

  • A cross-sectional, descriptive interview study was conducted.
  • Data were collected from 98 antidepressant users across 12 general practices in Odense, Denmark.
  • Key outcome measures included indication, justification, duration, dosage, side effects, and patient-reported outcomes (Hamilton depression rating, WONCA score).

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Main Results:

  • Depression was the primary indication for AD treatment in 72 patients.
  • Median treatment duration was 3 years, with 25% treated for over 10 years.
  • General practitioners identified 23 cases as problematic due to uncertain indication or suboptimal treatment choice, despite generally low AD doses and modest side effects. Patients often presented with high depression scores and poor functional status.

Conclusions:

  • Long-term AD treatment with low doses and uncertain indications characterize general practice prescribing.
  • A notable gap exists between current AD use in general practice and scientifically-backed recommendations.
  • Further research is needed to align clinical practice with evidence-based guidelines for antidepressant therapy.