Antidepressant drug use in primary care: a record linkage study in Tayside, Scotland.

Abstract

Depression is a common psychiatric disorder in general practice.1 There is consensus that antidepressants should be given in sufficient dose and for sufficiently long if treatment is to be effective.2 Tricyclic antidepressants carry warnings about their use in patients with cardiac diseases, and they have well known anticholinergic effects that could cause predictable toxicity. Selective serotonin uptake inhibitors are thought to be devoid of such effects. We studied the use and safety of antidepressant drugs in the community, with reference to their labelled warnings. We studied patient specific dispensed prescribing3 for antidepressant drugs and admissions to hospital for possible adverse effects over 14 months using a record linkage database that covers the population of Tayside, Scotland (about 400 000 subjects).4 The dose and duration of use of antidepressants was determined, as was the number …