A recent metanalysis has demonstrated that there are differences in efficacy and acceptability of commonly prescribed anti-depressants (Cipriani et al. 2009). Escitalopram, sertraline, venlafaxine and mirtazapine were the most effective.

We wished to find out whether the data from our own practice corresponded with the data from the metanalysis.

To compare the efficacy of anti-depressant monotherapies in patients with unipolar depression at Bedford Hospital, using discharge rates as the outcome measure.

We included all patients with unipolar depression on an antidepressant monotherapy in Bedford hospital in our analysis (145 in total). We examined the clinical notes for each patient to assess whether they had been discharged from the out-patient clinic after being prescribed the antidepressant. This allowed us to calculate discharge rates for each antidepressant monotherapy.

A higher percentage of patients prescribed Escitalopram were discharged from clinic compared to theother anti-depressant monotherapies.

Our results support the findings of the meta-analysis. The discharge rates from Bedford hospital suggest that Escitalopram in particular is the most efficacious.

This audit in a small group of patients suggests that Escitalopram leads to the highest discharge rate compared to the other monotherapies prescribed.