Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T04:27:21.636Z Has data issue: false hasContentIssue false
  • English
  • Français

Prescribing patterns of antidepressants in Europe: Results from the Factors Influencing Depression Endpoints Research (FINDER) study

Published online by Cambridge University Press:  16 April 2020

Michael Bauer ,
Brigitta U. Monz ,
Angel L. Montejo ,
Deborah Quail ,
Nicolas Dantchev ,
Koen Demyttenaere ,
Ana Garcia-Cebrian ,
Luigi Grassi ,
David G.S. Perahia  and
Catherine Reed
...Show all authors
Michael Bauer*
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universitat Dresden, Fetscherstrae 74, D-01307Dresden, Germany
Brigitta U. Monz
Affiliation:
Boehringer Ingelheim GmbH, D-55216Ingelheim, Germany
Angel L. Montejo
Affiliation:
University Hospital of Salamanca, Avda Comuneros 27, Salamanca37003, Spain
Deborah Quail
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, UK
Nicolas Dantchev
Affiliation:
Unite de Psychiatrie, Ho tel-Dieu, 1, place du Parvis Notre Dame, 75004Paris, France
Koen Demyttenaere
Affiliation:
Universitair Ziekenhuis Gasthuisberg, Herestraat 49, 3000Leuven, Belgium
Ana Garcia-Cebrian
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, UK
Luigi Grassi
Affiliation:
Section of Psychiatry, University of Ferrara, Corso Giovecca 203, 44100Ferrara, Italy
David G.S. Perahia
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, UK The Gordon Hospital, Bloomburg Street, London, SW1V 2RH, UK
Catherine Reed
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, UK
Andre Tylee
Affiliation:
Section of Primary Care Mental Health, Health Services and Population Research Department, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
*
* Corresponding author. Tel.: +49 351 458 2772; fax: +49 351 458 4324.
Get access

Abstract

Antidepressant prescribing patterns and factors influencing the choice of antidepressant for the treatment of depression were examined in the Factors Influencing Depression Endpoints Research (FINDER) study, a prospective, observational study in 12 European countries of 3468 adults about to start antidepressant medication for their first episode of depression or a new episode of recurrent depression. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly prescribed antidepressant (63.3% patients), followed by serotonin-norepinephrine reuptake inhibitors (SNRIs, 13.6%), but there was considerable variation across countries. Notably, tricyclic and tetracyclic antidepressants (TCAs) were prescribed for 26.5% patients in Germany. The choice of the antidepressant prescribed was strongly influenced by the previous use of antidepressants, which was significantly associated with the prescription of a SSRI (OR 0.64; 95% CI 0.54, 0.76), a SNRI (OR 1.49; 95% CI 1.18, 1.88) or a combination of antidepressants (OR 2.78; 95% CI 1.96, 3.96). Physician factors (age, gender, speciality) and patient factors (severity of depression, age, education, smoking, number of current physical conditions and functional syndromes) were associated with initial antidepressant choice in some models. In conclusion, the prescribing of antidepressants varies by country, and the type of antidepressant chosen is influenced by physician- as well as patient-related factors.

Keywords

AntidepressantsDepressionEuropeFINDERPrescribing patterns
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 1 , January 2008 , pp. 66 - 73
Copyright
Copyright © Elsevier Masson SAS 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

☆

FINDER was funded by Eli Lilly and Company Limited, Windlesham, UK and Boehringer Ingelheim GmbH, Ingelheim, Germany.

1

Tel.: +49 6132 779 3362; fax: +49 6132 774233.

2

Tel.: +34 923126 596/97; fax: +34 923 265482.

3

Tel.: +44 (0) 1276 483293; fax: +44 (0) 1276 484800.

4

Tel.: +33 (0) 142 34 84 35; fax: +33 (0) 142 34 84 33.

5

Tel.: +32 163 48705; fax: +32 163 48700.

6

Tel.: +44 (0) 1276 483028; fax: +44 (0) 1276 483192.

7

Tel.: +39 0532 236 409; fax +39 0532 212240.

8

Tel.: +44 (0) 1276 483755/+44 (0)20 8746 8733; fax: +44 (0) 1276 483711/+44 (0)20 8746 8711.

9

Tel.: +44 (0) 1276 483243; fax: +44 (0) 1276 483192.

10

Tel.: +44 (0) 20 7848 0150; fax: +44 (0) 20 7848 0333.

References

Agüera, L.F., Rojo, J.E., Ros, S., de la Gándara, J., de Pedro, J.M.Antidepressant combinations: epidemiological considerations. Acta Psychiatr Scand 2005;112(Suppl. 428):7–10.CrossRefGoogle Scholar
American Psychiatric Association, Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry 2000;157(Suppl. 4):1–45.Google Scholar
Anderson, I.M.Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord 2000;58:19–36.CrossRefGoogle ScholarPubMed
Anderson, I.M., Nutt, D.J., Deakin, J.F.W.Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 1993 British Association for Psychopharmacology guidelines. J Psychopharmacol 2000;14:3–20.CrossRefGoogle ScholarPubMed
Arroll, B., Macgillivray, S., Ogston, S., Reid, I., Sullivan, F., Williams, B.et al.Efficacy and tolerability of tricyclic antidepressants and SSRIs compared with placebo for treatment of depression in primary care: a meta-analysis. Ann Fam Med 2005;3:449–456.CrossRefGoogle ScholarPubMed
Bauer, M., Bschor, T., Pfennig, A., Whybrow, P.C., Angst, J., Versiani, M.et al.World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders in primary care. World J Biol Psychiatry 2007;8:67–104.CrossRefGoogle ScholarPubMed
Bauer, M., Whybrow, P.C., Angst, J., Versiani, M., Möller, H.J.World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: acute and continuation treatment of major depressive disorder. World J Biol Psychiatry 2002;3:5–43.CrossRefGoogle ScholarPubMed
Bauer, M., Whybrow, P.C., Angst, J., Versiani, M., Möller, H.J.World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 2: maintenance treatment of major depressive disorder and treatment of chronic depressive disorders and subthreshold depressions. World J Biol Psychiatry 2002;3:69–86.CrossRefGoogle ScholarPubMed
Brooks, R.with the EuroQoL Group EuroQol: the current state of play. Health Policy 1996;37:53–72.CrossRefGoogle ScholarPubMed
Claxton, A.J., Li, Z., McKendrick, J.Selective serotonin reuptake inhibitor treatment in the UK: risk of relapse or recurrence of depression. Br J Psychiatry 2000;177:163–168.CrossRefGoogle ScholarPubMed
De la Gandara, J., Aguera, L., Rojo, J.E., Ros, S., de Pedro, J.M.Use of antidepressant combinations: which, when and why? Results of a Spanish survey. Acta Psychiatr Scand 2005;112(Suppl. 428):32–36.CrossRefGoogle Scholar
ESEMeD/MHEDEA 2000 Investigators Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand 2004;109(Suppl. 420):55–64.CrossRefGoogle Scholar
Fegert, J.M., Kolch, M., Zito, J.M., Glaeska, G., Jahnsen, K.Antidepressant use in children and adolescents in Germany. J Child Adolesc Psychopharmacol 2006;16:197–206.CrossRefGoogle ScholarPubMed
Furukawa, T.A., McGuire, H., Barbui, C.Meta-analysis of effects and side effects of low dosage tricyclic antidepressants in depression: systematic review. BMJ 2002;325:991–1000.CrossRefGoogle ScholarPubMed
Garcia-Cebrian, A., Bauer, M., Montejo, A.L., Dantchev, N., Demyttenaere, K., Gandhi, P.et al.Characteristics of depressed outpatients entering the Factors Influencing Depression Endpoints Research (FINDER) study. Eur Psychiatry 2008;23:57–65.CrossRefGoogle Scholar
Guaiana, G., Andretta, M., Corbari, L., Mirandola, M., Sorio, A., D'Avanzo, B.et al.Antidepressant drug consumption and public health indicators in Italy, 1955 to 2000. J Clin Psychiatry 2005;66:750–755.CrossRefGoogle ScholarPubMed
Hansen, R.A., Gartlehner, G., Lohr, K.N., Gaynes, B.N., Carey, T.S.Efficacy and safety of second-generation antidepressants in the treatment of major depressive disorder. Ann Intern Med 2005;143:415–426.CrossRefGoogle ScholarPubMed
Lawrenson, R.A., Tyrer, F., Newson, R.B., Farmer, R.D.The treatment of depression in UK general practice: selective serotonin reuptake inhibitors and tricyclic antidepressants compared. J Affect Disord 2000;59:149–157.CrossRefGoogle ScholarPubMed
MacGillivray, S., Arroll, B., Hatcher, S., Ogston, S., Reid, I., Sullivan, F.et al.Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and meta-analysis. BMJ 2003;326:1014–1019.CrossRefGoogle ScholarPubMed
Martin-Agueda, B., Lopez-Munoz, F., Rubio, G., Guerra, J.A., Silva, A., Alamo, C.Management of depression in primary care: a survey of general practitioners in Spain. Gen Hosp Psychiatry 2005;27:305–312.CrossRefGoogle ScholarPubMed
Montejo, A.L., Gilaberte, I., Fombellida, C., Hylan, T.R., Sacristan, J.A.Pattern of usage of new antidepressants in clinical practice. Actas Luso Esp Neurol Psiquiatr 1998;26:75–81 [in Spanish]Google ScholarPubMed
National Institute for Clinical Excellence Depression: management of depression in primary and secondary care. Clinical Guideline No. 23 December 2004 Available from www.nice.org.uk [accessed 4.12.2007]Google Scholar
Olie, J.P., Elomari, F., Spadone, C., Lepine, J.P.Antidepressant consumption in the global population in France. Encephale 2002;28:411–417 [in French]Google ScholarPubMed
Paykel, E.S., Brugha, T., Fryers, T.Size and burden of depressive disorders in Europe. Eur Neuropsychopharmacol 2005;15:411–423.CrossRefGoogle ScholarPubMed
Peretti, S., Judge, R., Hindmarch, I.Safety and tolerability considerations: tricyclic antidepressants vs. selective serotonin reuptake inhibitors. Acta Psychiatr Scand 2000;102(Suppl. 403):17–25.CrossRefGoogle Scholar
Rush, A.J., Trivedi, M.H., Wisniewski, S.R., Stewart, J.W., Nierenberg, A.A., Thase, M.E.et al.Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. N Engl J Med 2006;354:1231–1242.CrossRefGoogle ScholarPubMed
Sclar, D.A., Robison, L.M., Skaer, T.L., Galin, R.S.What factors influence the prescribing of antidepressant pharmacotherapy? An assessment of national office-based encounters. Int J Psychiatry Med 1998;28:407–419.CrossRefGoogle ScholarPubMed
Sleath, B., Shih, Y.C.Sociological influences on antidepressant prescribing. Soc Sci Med 2003;56:1335–1344.CrossRefGoogle ScholarPubMed
Stafford, R.S., MacDonald, E.A., Finkelstein, S.N.National patterns of medication treatment for depression, 1987 to 2001. Primary Care Companion J Clin Psychiatry 2001;3:232–235.CrossRefGoogle ScholarPubMed
Tylee, A., Gastpar, M., Lepine, J.P., Mendlewicz, J.DEPRES II (Depression Research in European Society II): a patient survey of the symptoms, disability and current management of depression in the community. Int Clin Psychopharmacol 1999;14:139–151.Google Scholar
Ufer, M., Meyer, S.A., Junge, O., Selke, G., Volz, H.P., Hedderich, J.et al.Patterns and prevalence of antidepressant drug use in the German state of Baden-Wuerttemberg: a prescription based analysis. Pharmacoepidemiol Drug Saf 2007;16:1153–1160.CrossRefGoogle ScholarPubMed
Van Marwijk, H.W., Bijl, D., Ader, H.J., de Haan, M.Antidepressant prescription for depression in general practice in The Netherlands. Pharm World Sci 2001;23:46–49.CrossRefGoogle ScholarPubMed
Williams, J.W., Mulrow, C.D., Chiquette, E., Hitchcock, P., Aguilar, C., Cornell, J.A systematic review of newer pharmacotherapies for depression in adults: evidence report summary. Ann Intern Med 2000;132:743–756.CrossRefGoogle ScholarPubMed
Wohlreich, M.M., Martinez, J.M., Mallinckrodt, C.H., Prakash, A., Watkin, J.G., Fava, M.An open-label study of duloxetine for the treatment of major depressive disorder: comparison of switching versus initiating treatment approaches. J Clin Psychopharmacol 2005;25:552–560.CrossRefGoogle ScholarPubMed
Zetin, M., Hoepner, C.T., Bjornson, L.Rational antidepressant selection: applying evidence-based medicine to complex real-world patients. Psychopharmacol Bull 2006;39:38–104.Google ScholarPubMed
Zigmond, A.S., Snaith, R.P.The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–370.CrossRefGoogle ScholarPubMed
Zimmerman, M., Mattia, J.I., Posternak, M.A.Are subjects in pharmacological treatment trials for depression representative of patients in routine clinical practice?. Am J Psychiatry 2002;159:469–473.CrossRefGoogle ScholarPubMed
Zimmerman, M., Posternak, M., Friedman, M., Attiullah, N., Baymiller, S., Boland, R.et al.Which factors influence psychiatrists' selection of antidepressants?. Am J Psychiatry 2004;161:1285–1289.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.