Raymond Colette B, Morgan Steven G, Caetano Patricia A
Department of Pharmaceutical Services, Health Sciences Centre Hospital, Winnipeg, Manitoba, Canada.
Psychiatr Serv. 2007 Jan;58(1):79-84. doi: 10.1176/ps.2007.58.1.79.
Expenditures on antidepressants in Canada are rapidly increasing; yet few studies have analyzed the characteristics of antidepressant users. This study investigated the prevalence and incidence of antidepressant use in British Columbia over eight years.
Antidepressant utilization and demographic data were assessed for the population of British Columbia from 1996 to 2004. Prescription claims were identified within the PharmaNet database for serotonin reuptake inhibitors (SSRI), tricyclics, monoamine oxidase inhibitors, bupropion (categorized separately for smoking cessation), and "novel" antidepressants, such as venlafaxine. Incident utilization (dispensed "first" antidepressant after two years without an antidepressant claim) and prevalent utilization were analyzed. All cohort members were required to have continuous registration with British Columbia medical services for at least two years before the first antidepressant claim.
Prevalence of antidepressant use doubled, from 34 to 72 users per 1,000 population, between 1996 and 2004. The prevalence of particular classes of antidepressants also changed over time. Prevalence of novel antidepressants and SSRIs increased, although incidence of SSRIs decreased. Prevalent and incident use of bupropion for smoking cessation peaked in 1999 but then declined. Quarterly incident antidepressant use increased in 1998 and 1999 (6.5 and 11.3 users per 1,000) but decreased through 2004 (4.2 users per 1,000). Those aged 20 to 44 years and those aged 45 to 64 years showed the greatest peak in incident antidepressant use. A socioeconomic gradient in prescribing was observed.
Prevalent antidepressant use has increased dramatically since 1996. By contrast, incident use increased from 1998 to 1999 but then decreased through 2004. Many complex factors likely contribute to antidepressant prescribing patterns.
加拿大抗抑郁药的支出正在迅速增加；然而，很少有研究分析抗抑郁药使用者的特征。本研究调查了不列颠哥伦比亚省八年来抗抑郁药使用的患病率和发病率。
评估了1996年至2004年不列颠哥伦比亚省人口的抗抑郁药使用情况和人口统计数据。在PharmaNet数据库中识别出5-羟色胺再摄取抑制剂（SSRI）、三环类药物、单胺氧化酶抑制剂、安非他酮（用于戒烟单独分类）以及“新型”抗抑郁药（如文拉法辛）的处方申请。分析了新使用情况（在两年未使用抗抑郁药后首次配药的“第一剂”抗抑郁药）和现患使用情况。所有队列成员在首次使用抗抑郁药之前必须在不列颠哥伦比亚省医疗服务机构连续注册至少两年。
1996年至2004年间，抗抑郁药使用的患病率翻了一番，从每1000人中有34名使用者增至72名。特定类别的抗抑郁药的患病率也随时间发生了变化。新型抗抑郁药和SSRI的患病率增加，尽管SSRI的发病率下降。用于戒烟的安非他酮的现患和新使用情况在1999年达到峰值，但随后下降。1998年和1999年每季度新使用抗抑郁药的人数增加（每1000人中有6.5名和11.3名使用者），但到2004年有所下降（每1000人中有4.2名使用者）。20至44岁年龄段和45至64岁年龄段的人群新使用抗抑郁药的峰值最高。观察到了处方方面的社会经济梯度。
自1996年以来，抗抑郁药的现患使用情况大幅增加。相比之下，新使用情况在1998年至1999年增加，但到2004年有所下降。许多复杂因素可能导致了抗抑郁药的处方模式。
