Shi Nianwen, Durden Emily, Torres Amelito, Cao Zhun, Happich Michael
Thomson Reuters, Cambridge, MA 02140, USA.
Depress Res Treat. 2012;2012:815363. doi: 10.1155/2012/815363. Epub 2012 Jun 7.
Background. Knowledge about real-world use of duloxetine and venlafaxine XR to treat depression in the UK is limited. Aims. To identify predictors of duloxetine or venlafaxine XR initiation. Method. Adult depressed patients who initiated duloxetine or venlafaxine XR between January 1, 2006 and September 30, 2007 were identified in the UK's General Practice Research Database. Demographic and clinical predictors of treatment initiation with duloxetine and venlafaxine XR were identified using logistic regression. Results. Patients initiating duloxetine (n = 909) were 4 years older than venlafaxine XR recipients (n = 1286). Older age, preexisting unexplained pain, respiratory disease, and pre-period use of anticonvulsants, opioids, and antihyperlipidemics were associated with increased odds of initiating duloxetine compared to venlafaxine XR. Pre-period anxiety disorder was associated with decreased odds of receiving duloxetine. Conclusion. Initial treatment choice with duloxetine versus venlafaxine XR was primarily driven by patient-specific mental and medical health characteristics. General practitioners in the UK favor duloxetine over venlafaxine XR when pain conditions coexist with depression.
背景。在英国,关于度洛西汀和文拉法辛缓释剂在现实世界中用于治疗抑郁症的知识有限。目的。确定度洛西汀或文拉法辛缓释剂起始治疗的预测因素。方法。在英国全科医学研究数据库中识别出2006年1月1日至2007年9月30日期间开始使用度洛西汀或文拉法辛缓释剂的成年抑郁症患者。使用逻辑回归确定度洛西汀和文拉法辛缓释剂起始治疗的人口统计学和临床预测因素。结果。开始使用度洛西汀的患者(n = 909)比使用文拉法辛缓释剂的患者(n = 1286)年长4岁。与文拉法辛缓释剂相比,年龄较大、既往存在无法解释的疼痛、呼吸系统疾病以及在治疗前使用抗惊厥药、阿片类药物和抗高脂血症药物与开始使用度洛西汀的几率增加有关。治疗前焦虑症与接受度洛西汀的几率降低有关。结论。度洛西汀与文拉法辛缓释剂的初始治疗选择主要由患者特定的精神和健康特征驱动。当疼痛状况与抑郁症并存时,英国的全科医生更倾向于使用度洛西汀而非文拉法辛缓释剂。