Jakimavicius Mantas, Sveikata Audrius, Vainauskas Paulius, Jankūnas Rimas, Mikucionyte Loreta, Sapoliene Agne, Smigelskas Kastytis
Department of Analytical and Toxicological Chemistry, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2007;43(5):412-8.
Depression is one of the leading causes of disability worldwide, affecting 121 million people in whole world. In many developed countries, the number of prescriptions for antidepressants increased steeply during the 1990s. The objective of the present study was to evaluate the antidepressant prescribing patterns in all regions of Lithuania during 2003-2004, to analyze the use within different antidepressant groups, and to examine trends in age- and gender-specific antidepressant use. Antidepressants were classified into three groups according to Anatomic Therapeutic Chemical (ATC) Classification specifying the defined daily doses. The results of our study show an increase in the use of reimbursed antidepressants except tricyclic in 2004 when compared to 2003. Increase in the use of selective serotonin reuptake inhibitors and other nontricyclic antidepressants is probably related to their better tolerability, improved risk-benefit ratio, and less toxicity in overdose. There was no increase in the percentage of consumed selective serotonin reuptake inhibitors in elderly patients when compared with younger ones, despite elderly patients are most likely to benefit from reduced sedation, less antimuscarinic and less cardiac toxicity of selective serotonin reuptake inhibitors. The prevalence of the antidepressant use is the highest among middle-aged people (40-59 years), while the young (under 20) and elderly (older than 70) patients receive mostly selective serotonin reuptake inhibitors. Additional studies should be carried out in order to assess drug-prescribing patterns in accordance with the guidelines of depression treatment in Lithuania considering diagnosis, dosage, and duration of treatment.
抑郁症是全球导致残疾的主要原因之一，影响着全世界1.21亿人。在许多发达国家，20世纪90年代抗抑郁药的处方数量急剧增加。本研究的目的是评估2003 - 2004年立陶宛所有地区的抗抑郁药处方模式，分析不同抗抑郁药组内的使用情况，并研究年龄和性别特异性抗抑郁药使用的趋势。根据解剖治疗化学（ATC）分类法将抗抑郁药分为三组，并指定了限定日剂量。我们的研究结果表明，与2003年相比，2004年除三环类药物外，可报销抗抑郁药的使用有所增加。选择性5-羟色胺再摄取抑制剂和其他非三环类抗抑郁药使用的增加可能与其更好的耐受性、改善的风险效益比以及过量时较低的毒性有关。与年轻患者相比，老年患者中消耗的选择性5-羟色胺再摄取抑制剂的百分比没有增加，尽管老年患者最有可能从选择性5-羟色胺再摄取抑制剂减少的镇静作用、较少的抗毒蕈碱作用和较低的心脏毒性中获益。抗抑郁药的使用在中年人（40 - 59岁）中最为普遍，而年轻人（20岁以下）和老年人（70岁以上）患者大多使用选择性5-羟色胺再摄取抑制剂。应开展进一步研究，以便根据立陶宛抑郁症治疗指南，从诊断、剂量和治疗持续时间方面评估药物处方模式。
