Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Psychiatry Investig. 2011 Sep;8(3):234-44. doi: 10.4306/pi.2011.8.3.234. Epub 2011 Aug 26.
This study aimed to investigate antidepressant prescribing patterns, including initial choice, switching and combining, and concomitant use of non-antidepressant agents, for depressive disorders in naturalistic clinical care settings in Korea.
Patients with depressive disorder were recruited from both outpatient and inpatient settings in 18 hospitals from all over Korea. Treatment was performed in naturalistic patterns based on each clinician's decision. Data were collected on the prescription of antidepressants and concomitant agents from baseline to 12-week follow-up.
Selective serotonin reuptake inhibitors (SSRIs) were the most commonly prescribed initial antidepressant (48.9%), followed by newer dual-action antidepressants (45.8%). When an SSRI was the initial antidepressant, 46.2% of patients whose medication was changed were moved to newer dual-action antidepressants, and 67.4% of combination cases were combined with newer dual-action ones. When a newer dual-action antidepressant was the initial antidepressant, 70.6% of patients whose medication was changed were moved to SSRIs, and other antidepressants including tricyclic antidepressants were most commonly added for combination treatment (50% of combination cases). During the treatment period, 20.6% of antidepressants prescribed were augmented by non-antidepressant agents, and 75.1% were used concomitantly with anxiolytics or hypnotics. The most commonly used concomitant non-antidepressant agent was quetiapine.
The selection of antidepressants and the concomitant use of non-antidepressant agents are becoming increasingly diversified, and the results of this study reflect changes in the prescribing pattern in actual Korean practices.
本研究旨在调查韩国自然临床环境中治疗抑郁障碍的抗抑郁药处方模式,包括初始选择、转换和联合以及非抗抑郁药的伴随使用。
在韩国的 18 家医院中,从门诊和住院患者中招募了患有抑郁障碍的患者。根据每位临床医生的决定,按照自然模式进行治疗。从基线到 12 周随访期间,收集了抗抑郁药和伴随药物的处方数据。
选择性 5-羟色胺再摄取抑制剂(SSRIs)是最常被处方的初始抗抑郁药(48.9%),其次是新型双重作用抗抑郁药(45.8%)。当 SSRI 作为初始抗抑郁药时,46.2%的药物转换患者被转用新型双重作用抗抑郁药,67.4%的联合治疗患者与新型双重作用抗抑郁药联合使用。当新型双重作用抗抑郁药作为初始抗抑郁药时,70.6%的药物转换患者被转用 SSRI,其他抗抑郁药(包括三环抗抑郁药)最常用于联合治疗(50%的联合治疗患者)。在治疗期间,20.6%的处方抗抑郁药被非抗抑郁药增效,75.1%与抗焦虑药或催眠药同时使用。最常使用的伴随非抗抑郁药是喹硫平。
抗抑郁药的选择和非抗抑郁药的伴随使用变得越来越多样化,本研究的结果反映了韩国实际实践中处方模式的变化。