Comparison of the Effectiveness of Different Antidepressants in Preventing Psychiatric Rehospitalization.

OBJECTIVE

Patients with major depressive disorder (MDD) often face poor health outcomes. Additionally, patients with multiple hospitalizations tend to have worse predicted disease prognosis. Antidepressant medications remain a first-line treatment option for MDD, but data evaluating the effects of different antidepressants on psychiatric readmission rates is lacking. The objective of this study was to assess readmission rates based on antidepressant selection upon discharge from an inpatient psychiatric hospitalization.

METHODS

This was a single-center, retrospective chart review evaluating psychiatric readmission rates of adults with MDD discharged on antidepressant therapy. The primary outcome was to compare 30-day psychiatric rehospitalization rates based on antidepressant treatment and secondary outcomes included six-month and one-year psychiatric rehospitalization based on antidepressant treatment. Odds ratios (OR), 95% confidence intervals (CI), and p-values were calculated to determine the odds of readmission in patients who were discharged on each antidepressant compared to patients who were discharged on an antidepressant other than that particular antidepressant.

RESULTS

Patients who were discharged on sertraline were four times less likely to be readmitted within 30 days compared to the combined readmission rate of other antidepressants or multiple antidepressants (OR: 0.228, 95%CI: 0.053-0.978, p<0.05). Meanwhile, patients discharged on any combination of multiple antidepressants were more likely to be readmitted than patients discharged on only one antidepressant (OR: 4.517, 95%CI: 1.581-12.908, p<0.05). The antidepressant medications included in the study were bupropion, duloxetine, escitalopram, fluoxetine, mirtazapine, paroxetine, sertraline, trazodone, and venlafaxine.

CONCLUSION

Careful consideration should be taken when choosing antidepressant therapy for inpatient psychiatric patients as this may impact relapse of symptoms and readmission rates. Further research is needed to evaluate other factors that may influence psychiatric readmissions for MDD.