Rosholm J U, Gram L F, Isacsson G, Hallas J, Bergman U
Department of Clinical Pharmacology, Odense University, Denmark.
Eur J Clin Pharmacol. 1997;52(3):205-9. doi: 10.1007/s002280050275.
To study whether the newer antidepressants have changed the patterns of antidepressant use, and whether the claimed better adverse effect profile of the lower antidepressants is reflected in their use as monitored by a prescription database.
By means of a prescription database (OPED), the use of antidepressants from 1991 to 1993 in Odense, Denmark, was analysed.
The 1-year prevalence of antidepressant use increased significantly from 1.60% to 2.00%, which still is below the claimed 1-year prevalence of depression of at least 5%. The increase was mainly due to a rapidly increasing use of the newer antidepressants, accompanied by a moderate decline in the use of older antidepressants (mainly tricyclic antidepressants). The patterns of antidepressant use were very polymorphic, with about 5% being on continuous use for all 3 years and groups of each 20-30% being treated with: (1) several series or (2) one series or (3) only by one prescription. The share of patients presenting only one prescription (20%) was the same for older and newer antidepressants. Likewise, the rate of shifts from older to newer antidepressants or vice versa was the same (7% vs 6%). The duration of treatment did not differ much between older and newer antidepressants. Relative to the defined daily dose (DDD), the older antidepressants were given in much lower doses (median 0.63 DDD) than the newer antidepressants (median 1.05 DDD).
It is concluded that many depressed patients are still not receiving antidepressant treatment and that the claimed better adverse effect profile of the newer antidepressants was not clearly reflected in their use.
研究新型抗抑郁药是否改变了抗抑郁药的使用模式，以及在处方数据库监测下，所宣称的新型抗抑郁药更好的不良反应特征是否体现在其使用情况中。
通过一个处方数据库（OPED），分析了1991年至1993年丹麦欧登塞市抗抑郁药的使用情况。
抗抑郁药的1年患病率从1.60%显著增加到2.00%，但仍低于所宣称的至少5%的抑郁症1年患病率。这种增加主要是由于新型抗抑郁药的使用迅速增加，同时老一代抗抑郁药（主要是三环类抗抑郁药）的使用适度下降。抗抑郁药的使用模式非常多样，约5%的患者连续3年使用，每20 - 30%的患者分为三组接受治疗：（1）几种药物联用；（2）一种药物单用；（3）仅用一张处方。老一代和新型抗抑郁药中仅开具一张处方的患者比例相同（均为20%）。同样，从老一代抗抑郁药转换为新型抗抑郁药或反之的比例相同（分别为7%和6%）。老一代和新型抗抑郁药的治疗持续时间差异不大。相对于限定日剂量（DDD），老一代抗抑郁药的给药剂量（中位数0.63 DDD）远低于新型抗抑郁药（中位数1.05 DDD）。
得出结论认为，许多抑郁症患者仍未接受抗抑郁药治疗，且所宣称的新型抗抑郁药更好的不良反应特征在其使用中未得到明确体现。
