Rosholm J U, Gram L F, Damsbo N, Hallas J
Odense Universitet, Afdeling for Klinisk Farmakologi.
Ugeskr Laeger. 1997 Jan 13;159(3):280-3.
In order to elucidate potential problems concerning the use of antidepressants in general practice, 98 randomly selected antidepressant users from 12 general practices were interviewed. The primary indication for antidepressant treatment was depression (72 patients), partly regular depression (therapeutic/prophylactic treatment) (n = 39), partly depressive tendencies (n = 32) (one patient no information). Median treatment duration was three years; 25% had been in treatment for more than 10 years. The general practitioners judged the treatment problematic/unacceptable in 23 cases, largely because of uncertain indication or because other or no treatment was considered better for the patient. Side effects were modest. The patients often had a relatively high depression score and poor status according to the WONCA-scale. The use of low doses, long duration of treatment, and uncertainty about the relevance of the treatment are important features in the use of antidepressants by general practitioners. The use of antidepressants in general practice differs from the scientifically-based recommendations.
为了阐明在全科医疗中使用抗抑郁药可能存在的问题，我们从12家全科诊所中随机抽取了98名抗抑郁药使用者进行访谈。抗抑郁药治疗的主要适应症是抑郁症（72例患者），部分是定期抑郁症（治疗/预防性治疗）（n = 39），部分是抑郁倾向（n = 32）（1例患者无信息）。治疗持续时间的中位数为三年；25%的患者接受治疗超过10年。全科医生认为23例治疗存在问题/不可接受，主要是因为适应症不明确，或者认为其他治疗或不治疗对患者更好。副作用较小。根据WONCA量表，患者通常抑郁评分相对较高且状态较差。低剂量使用、治疗持续时间长以及治疗相关性的不确定性是全科医生使用抗抑郁药的重要特征。全科医疗中抗抑郁药的使用与基于科学的建议不同。
