Abarbanel Mental Health Center and the Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Int J Psychiatry Clin Pract. 2008;12(1):31-5. doi: 10.1080/13651500701419701.
Objective. Recent meta-analyses have argued that there are no clinically significant differences between various selective serotonin reuptake inhibitors (SSRIs) or between SSRIs and other antidepressants. Analysis of large-scale national prescription databases may offer a unique opportunity to see whether this premise holds true in actual practice. National databases however, should be viewed with caution as they reveal only limited information about efficacy and tolerability. Methods. The number of antidepressants prescribed annually (October 2004 to September 2005), as well as the class of drug and the use of any additional psychotropics were obtained from the Israeli subsidiary of Intercontinental Marketing Services (IMS) Health. Results. During the 12-month study period there were 2,107,763 prescriptions of antidepressants reported by IMS in Israel. Compared to other drug classes, the SSRIs were used significantly more often as a sole therapy (chi-square=1343, df=3, P<0.0001). Of the SSRIs, escitalopram was the most frequently prescribed (79%) as monotherapy, followed by fluoxetine with 72% and <70% for the other SSRIs. The most frequently prescribed additional psychotropic was a benzodiazepine, in the range of 38 to nearly 50%. Conclusion. Antidepressants vary significantly in their use as a single ("monotherapy") drug. The use of additional psychotropics could reflect either the presence of symptoms not well covered by a particular antidepressant or for addressing side effects particular to a certain class of antidepressants.The premise that all SSRIs are equal is not reflected in this current examination.
最近的荟萃分析认为，各种选择性 5-羟色胺再摄取抑制剂（SSRIs）之间或 SSRI 与其他抗抑郁药之间不存在临床显著差异。对大型国家处方数据库进行分析可能提供了一个独特的机会，以了解这一前提在实际实践中是否成立。然而，国家数据库应谨慎看待，因为它们仅能提供关于疗效和耐受性的有限信息。
从 Intercontinental Marketing Services（IMS）Health 的以色列子公司获取每年（2004 年 10 月至 2005 年 9 月）开处的抗抑郁药数量、药物类别以及任何其他精神药物的使用情况。
在 12 个月的研究期间，IMS 在以色列共报告了 2107763 份抗抑郁药处方。与其他药物类别相比，SSRIs 作为单一疗法的使用频率明显更高（卡方=1343，df=3，P<0.0001）。在 SSRIs 中，艾司西酞普兰作为单一疗法的处方频率最高（79%），其次是氟西汀，其他 SSRIs 的比例为 72%至<70%。开处最频繁的其他精神药物是苯二氮䓬类药物，比例在 38%至近 50%之间。
抗抑郁药在作为单一药物（“单一疗法”）使用时差异显著。使用其他精神药物可能反映出特定抗抑郁药无法有效缓解的症状，或者是针对特定类别的抗抑郁药的特定副作用。这一当前检查结果并未反映出所有 SSRIs 都平等的前提。
