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Antidepressant dose patterns in Swedish clinical practice
K Bingefors1, D Isacson, L von Knorring
1Department of Psychiatry, University Hospital, Uppsala University, Sweden.
International Clinical Psychopharmacology
|February 18, 1998
Summary
Antidepressant dosages varied by diagnosis and treatment phase. Tricyclic antidepressants and selective serotonin reuptake inhibitors were often underdosed initially for depression, suggesting suboptimal treatment and higher real-world costs.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Psychiatry
Background:
- Antidepressant therapy is crucial for managing depression.
- Accurate dosing is essential for treatment efficacy.
- Previous studies have indicated variability in antidepressant prescribing patterns.
Purpose of the Study:
- To analyze antidepressant prescribing patterns in Sweden from 1991 to 1996.
- To investigate dose variations based on diagnosis and treatment phase.
- To evaluate the adequacy of prescribed antidepressant doses in clinical practice.
Main Methods:
- Utilized data from the Swedish Diagnosis and Therapy Survey (1991-1996).
- Analyzed prescribing data for antidepressants, focusing on tricyclic antidepressants and selective serotonin reuptuptake inhibitors.
- Compared doses prescribed during new treatment versus continued treatment for depression.
Main Results:
- Significant differences in prescribed antidepressant doses were observed across diagnoses.
- Tricyclic antidepressants were frequently prescribed at sub-therapeutic doses for depression.
- Higher doses were administered during continued treatment compared to initial treatment, indicating dose titration.
Conclusions:
- Optimal antidepressant dosing in clinical practice may not yet be established for newer agents.
- Real-world treatment costs may exceed those calculated from standard dose recommendations.
- Dose titration is a common practice for tricyclic antidepressants and common selective serotonin reuptake inhibitors in depression management.