Soares Sofia, Rosado Tiago, Santos Vítor Hugo, Rei Cristina, Amantegui Patricia, Pissarra da Costa António, Chaves Telma, Valente Rita, Duarte Fábio, Pacheco Susana, Martins Marco, Dias Kátia, Costa Patricia, Costa Rui, Castro Sílvia, Sousa Diana, Figueiredo Diana, Soares Isabel, Mouta Salomé, Jesus Bianca, Pires Ana, Ribeiro Cândida, Lobo Sónia, Correia Leonor, Malés Sofia, Vale Fátima, Moita Carina, Moura Carolina, Sousa Joana, Afonso Luís Rafael, Costa Rita Santinho, Barroso Mário, Gallardo Eugenia
RISE-Health, Departamento de Ciências Médicas, Faculdade de Ciências da Saúde, Universidade da Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal.
Laboratório de Fármaco-Toxicologia-Ubimedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal.
Healthcare (Basel). 2025 Aug 31;13(17):2177. doi: 10.3390/healthcare13172177.
: Mental disorders are a growing global concern, with depression being among the most prevalent. Portugal ranks second in antidepressant consumption within the OECD, following a threefold increase between 2000 and 2020. In inland regions such as Beira Interior, reduced healthcare services and distance from major hospitals further complicate access to care. This study analysed 142 patients from Beira Interior undergoing antidepressant therapy to characterise their demographic and clinical profile and to assess associations with adverse effects. A cross-sectional survey collected demographic data, clinical diagnoses, prescribed antidepressants, concomitant medications, and reported adverse effects. Both descriptive and inferential statistical analyses were performed. Most participants were female (81.0%), with a mean age of 57.8 years. Major depression was the most common diagnosis (76.1%). Selective serotonin reuptake inhibitors (47.4%) and trazodone (27.8%) were the most prescribed agents. Treatment had lasted one to five years in 59.9% of cases. Concomitant use of benzodiazepines (76.8%) and antipsychotics (48.6%) was frequent. Reported adverse effects included anticholinergic symptoms (38.7%) and confusion/agitation (26.8%). Women were more likely to use serotonin modulators, while patients >64 years had higher odds of using tetracyclic/unicyclic antidepressants, serotonin modulators, and multiple antidepressants. These classes were significantly associated with increased adverse effects. The findings reveal important risks related to polypragmasia and adverse reactions, underscoring the need for individualised prescribing, rigorous monitoring, and strict adherence to guidelines. Larger, stratified, and longitudinal studies are needed to clarify causality and optimise treatment outcomes.
精神障碍是一个日益受到全球关注的问题，抑郁症是最常见的精神障碍之一。在经合组织（OECD）国家中，葡萄牙的抗抑郁药消费量位居第二，2000年至2020年间增长了两倍。在贝拉内陆等内陆地区，医疗服务减少以及与大型医院距离较远，使得获得医疗服务变得更加复杂。本研究分析了贝拉内陆地区142名接受抗抑郁治疗的患者，以描述他们的人口统计学和临床特征，并评估与不良反应的关联。一项横断面调查收集了人口统计学数据、临床诊断、处方抗抑郁药、伴随用药以及报告的不良反应。进行了描述性和推断性统计分析。大多数参与者为女性（81.0%），平均年龄为57.8岁。重度抑郁症是最常见的诊断（76.1%）。选择性5-羟色胺再摄取抑制剂（47.4%）和曲唑酮（27.8%）是最常处方的药物。59.9%的病例治疗持续了1至5年。经常同时使用苯二氮䓬类药物（76.8%）和抗精神病药物（48.6%）。报告的不良反应包括抗胆碱能症状（38.7%）和意识模糊/激动（26.8%）。女性更有可能使用5-羟色胺调节剂，而64岁以上的患者使用四环/单环抗抑郁药、5-羟色胺调节剂和多种抗抑郁药的几率更高。这些药物类别与不良反应增加显著相关。研究结果揭示了与多药并用和不良反应相关的重要风险，强调了个性化处方、严格监测以及严格遵循指南的必要性。需要进行更大规模、分层和纵向研究以阐明因果关系并优化治疗结果。
