Rosholm J U, Andersen M, Gram L F
Institute of Public Health, Center of Clinical Pharmacology, University of Southern Denmark-Odense, Winsløwparken 19, DK-5000 Odense C, Denmark.
Eur J Clin Pharmacol. 2001 Mar;56(12):923-9. doi: 10.1007/s002280000234.
The aim of the present study was to analyse the utilisation of antidepressants (ADs) and to compare the utilisation of the various ADs with special reference to duration of treatment courses.
From the Odense Pharmacoepidemiologic Database (OPED), all users of and prescriptions for ADs in the County of Funen, Denmark (about 470,000 inhabitants), were identified for each year from 1992 to 1997 (6 years). Duration of treatment courses was calculated for the first incident period of continuous use of one AD and was compared for the various ADs using Kaplan-Meiers survival statistics with log rank tests. Continuous use was defined as use of a minimum of one tablet per day. Furthermore, the proportion of users presenting only one prescription was determined for each AD.
In total, 37,598 patients presented 392,524 prescriptions during 1992-1997. The 1-year prevalence rose from 2.1% to 4.1% in 1997 and the incidence was 1.3% in 1997. The 1-year prevalence increased with age up to 16.5% in 1997 for patients aged 90 years or older. Citalopram was the most-used AD, but there were still a considerable number of patients commencing treatment with TCAs in 1997. Median duration of treatment courses was 196 days for TCAs versus 120 days for SSRIs (P < 0.0001). Duration of treatment courses increased with age. The proportion of users presenting only one prescription was 22% for the SSRIs versus 33% for tricyclic antidepressants (TCAs).
This study showed that the use of ADs continues to increase because of the increase in the use of the new ADs. There was, however, still a considerable number of patients who started on TCA treatment in 1997. For repeated prescriptions, TCAs were used for longer times than SSRIs. In the very old, there was an apparently inappropriate high use of ADs.
本研究旨在分析抗抑郁药（ADs）的使用情况，并特别参照治疗疗程的时长，比较各类抗抑郁药的使用情况。
从欧登塞药物流行病学数据库（OPED）中，确定了1992年至1997年（6年）期间丹麦菲英岛郡（约47万居民）所有抗抑郁药的使用者及处方。计算首次连续使用一种抗抑郁药的疗程时长，并使用Kaplan-Meiers生存统计和对数秩检验比较各类抗抑郁药的疗程时长。连续使用定义为每天至少服用一片药。此外，还确定了每种抗抑郁药仅开具一张处方的使用者比例。
1992年至1997年期间，共有37598名患者开具了392524张处方。1997年1年患病率从2.1%升至4.1%，1997年发病率为1.3%。1997年，90岁及以上患者的1年患病率随年龄增长升至16.5%。西酞普兰是使用最多的抗抑郁药，但1997年仍有相当数量的患者开始使用三环类抗抑郁药（TCA）治疗。三环类抗抑郁药的治疗疗程中位数为196天，而选择性5-羟色胺再摄取抑制剂（SSRI）为120天（P<0.0001）。治疗疗程时长随年龄增长。仅开具一张处方的使用者比例，选择性5-羟色胺再摄取抑制剂为22%，三环类抗抑郁药为33%。
本研究表明，由于新型抗抑郁药使用增加，抗抑郁药的使用持续上升。然而，1997年仍有相当数量的患者开始使用三环类抗抑郁药治疗。对于重复处方，三环类抗抑郁药的使用时间比选择性5-羟色胺再摄取抑制剂长。在高龄患者中，抗抑郁药的使用明显不当且比例较高。
