Abstract
Depression affects nearly 350 million people worldwide. Local data indicates that approximately 17% of all South Africans will experience at least one episode of depression in their lifetime. Depressive disorders contribute significantly towards overall morbidity and increased risk for suicide. Antidepressant therapy remains one of the cornerstones in the management of depressive disorders. Although the efficacy of antidepressive drugs is continuously subjected to criticism, thousands of controlled clinical trials have shown, and will continue to show, their benefit in the effective treatment of depressive disorders. Since the introduction of antidepressants in the early 1950s, researchers have been searching for an ideal antidepressant able to adequately reduce, preserve and prevent features of depression with the absence of side effects. This article summarizes the currently available antidepressant drugs in South Africa. Discontinued products have been omitted and newly registered agents have been added. This review does not contain reference to any experimental drug, or substances not yet available for local use.
Highlights
It is estimated that 350 million people worldwide suffer from depression, and predictions indicate that by the year 2020 Major Depressive Disorder (MDD) will be the second largest contributor to the global burden of disease, only being surpassed by heart disease.[1]
The choice of medication should be guided by a careful assessment of symptoms, patient comorbid psychiatric or general medical conditions, contraindications as well as an analysis of therapeutic benefits and side effects, potential drug interactions and cost
selective serotonin reuptake inhibitors (SSRIs) or serotonin-noradrenaline reuptake inhibitors (SNRIs) should be considered as first-line treatment for mild to moderate depression
Summary
It is estimated that 350 million people worldwide suffer from depression, and predictions indicate that by the year 2020 Major Depressive Disorder (MDD) will be the second largest contributor to the global burden of disease, only being surpassed by heart disease.[1]. Suicide is the second leading cause of death in the age group 15–29 years.[3] Limited data regarding the epidemiology of MDD in South Africa is available, studies conducted from 2008 to 2012, showed a 41% increase in the incidence of mental disorders. From these disorders, MDD was shown to have a 12 month prevalence of 16.5% and a lifetime prevalence of 30.3%.4. MDD was shown to have a 12 month prevalence of 16.5% and a lifetime prevalence of 30.3%.4 Research done by the Faculty of Mental Health at the University of Cape Town shows that nearly three quarters of South Africans diagnosed with mental illness are not receiving treatment, and that 11% of all non-natural deaths in South Africa are the result of suicide.[5]
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