Antidepressant Consumption Research Articles

Impact of COVID-19 pandemic and lockdowns on the consumption of anxiolytics, hypnotics and antidepressants according to age groups: a French nationwide study.

Previous studies have shown a negative impact of the COVID-19 pandemic and its associated sanitary measures on mental health, especially among adolescents and young adults. Such a context may raise many concerns about the COVID-19 pandemic long-term psychological effects. An analysis of administrative databases could be an alternative and complementary approach to medical interview-based epidemiological surveys to monitor the mental health of the population. We conducted a nationwide study to describe the consumption of anxiolytics, antidepressants and hypnotics during the first year of the COVID-19 pandemic, compared to the five previous years. A historic cohort study was conducted by extracting and analysing data from the French health insurance database between 1 January 2015 and 28 February 2021. Individuals were classified into five age-based classes. Linear regression models were performed to assess the impact of the COVID-19 pandemic period on the number of drug consumers, in introducing an interaction term between time and COVID-19 period. Since March 2020, in all five age groups and all three drug categories studied, the number of patients reimbursed weekly has increased compared to the period from January 2015 to February 2020. The youngest the patients, the more pronounced the magnitude. Monitoring the consumption of psychiatric medications could be of great interest as reliable indicators are essential for planning public health strategies. A post-crisis policy including reliable monitoring of mental health must be anticipated.

New Method for the Monitoring of Antidepressants in Oral Fluid Using Dried Spot Sampling.

The increase in the consumption of antidepressants is a public health problem worldwide, as these are a class of compounds widely used in the treatment of several illnesses, such as depression and anxiety. This work aimed to develop and optimize a method for the quantification of a number of antidepressants and their metabolites (fluoxetine, venlafaxine, O-desmethylvenlafaxine, citalopram, sertraline, and paroxetine) in 100 µL of oral fluid using the dried saliva spots (DSS) sampling approach and gas chromatography coupled with tandem mass spectrometry (GC–MS/MS). The method was validated, presenting linearity within the studied range, with detection and quantification limits ranging between 10 and 100 ng/mL, and coefficients of determination (R2) of at least 0.99 for all analytes. Recoveries were between approximately 13 and 46%. The analysis of precision and accuracy presented acceptable coefficients of variation and relative errors, considering the criteria usually accepted in the validation of bioanalytical procedures. The method herein described is the first to be reported using DSS for the extraction of antidepressants, proving to be a sensitive, simple, and fast alternative to conventional techniques, and capable of being routinely applied in clinical and forensic toxicology scenarios.

Risk factors for burnout and depression in healthcare workers: The national AMADEUS study protocol

ContextBurnout is an international phenomenon defined as a state of professional exhaustion. It can lead to depression and have major economic and organizational impacts. Previous studies of healthcare professionals in France have focused on physicians, but none to date have explored other healthcare professions. ObjectivesThe main objective of our study is to determine the prevalence of burnout among healthcare workers. The secondary objectives are to explore the associations of burnout with professional and psycho-social factors and the risk of depression, professional harassment, sexual harassment, sexual-orientation based discrimination, consumption of antidepressants, anxiolytics and also the lifestyle of the individual: smoking, alcohol consumption, coffee consumption, physical activity and sleep quality. Materials and methodsThe survey will take the form of a voluntary and anonymous online questionnaire carried out on the FramaForm1® platform and will be disseminated via social networks, professional networks and mailings. Study PopulationSenior doctors, interns, directors of care, nurses, head nurses and senior head nurses, physiotherapists and occupational therapists, dieticians, radiology technicians, laboratory technicians, psychologists, nurses’ aides, auxiliary nurses and midwives will be included. Collected dataBurnout will be measured with the Maslach Inventory burnout (MBI) questionnaire, work environment with the Karasek questionnaire and anxiety, depression risk with the Center for Epidemiologic Studies- Depression (CES-D), physical activity with the Global Physical Activity Questionnaire (GPAQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). EthicsThis protocol has been accepted by the ethical committee (IRB n°C08/21.01.06.93911, CNIL). Expected resultsBased on international studies, we expect a high rate of burnout with disparities according to profession, socio-demographic data, seniority and type of service. We also expect a significant rate of untreated depression. This study will provide evidence for policy makers to implement collective strategies to reduce burnout and depression in the different populations studied.

Prescription of anxiolytics, sedatives, hypnotics and antidepressants in outpatient, universal care during the COVID-19 pandemic in Portugal: a nationwide, interrupted time-series approach

BackgroundThe COVID-19 pandemic has had a significant impact on the population’s mental health. However, its impact on the consumption of anxiolytics, sedatives, hypnotics and antidepressants remains to be evaluated. Hence,...

428 - Reflections on geriatric psychopharmacology in Portugal

Background:The most common psychiatric illnesses include depressive and anxiety disorders. However, the gap between therapeutic indication and pharmacological consumption is evident, with anxiolytics and antidepressants being some of the most prescribed drugs for the general population and, in particular, for the elderly. However, several of these psychotropic drugs are part of the list of potentially inappropriate medications for the elderly. Thus, the question arises: is the appropriate care being given to older patients, in this domain?Research objective:This work aims to reflect on the current structure of the mental health care network for elderly patients, focusing on consumption patterns among thevarious categories of psychotropic drugs and their physiological impact, taking into account the particularities of the target population.Method:A non-systematic review of the literature is presented. Bibliographic selection was carried out through keyword research in MEDLINE, Google Scholar and also by cross-referencing between articles.Results:In Portugal it was possible to infer that the consumption of anxiolytics and antidepressants increased ans was in line with the European trend. On the other hand, there has been a downward trend in the consumption of sedatives and hypnotics, opposite to the general trend in Europe. Due to changes related to pharmacokinetics and pharmacodynamics, older patients are more susceptible to the development of adverse reactions, the prevalence of potentially inappropriate medications is high in the context of mental health care. Switching drugs such as benzodiazepines, certain antipsychotics, tricyclic antidepressants and first-generation antihistamines significantly reduced the risk of adverse reactions.Discussion:Mental health care policies must be aligned with the conscious use of psychotropic drugs in the elderly population, at risk of the main objective, their well- being and care, being compromised.

Spinal cord stimulation in severe cases of complex regional pain syndrome: A retrospective cohort study with long-term follow-up.

Complex regional pain syndrome (CRPS) is a debilitating pain condition often resistant to standard treatment modalities. In these cases, spinal cord stimulation (SCS) can be an option, but the effect on CRPS remains disputed. We aimed to assess the long-term effect of SCS on CRPS. We retrospectively analysed 51 CRPS patients implanted with an SCS system at the University Hospitals in Aarhus or Odense, Denmark, with a median follow-up time of 4.4years. Primary outcomes were pain intensity on a numeric rating scale (NRS) and the Patients' Global Impression of Change (PGIC). Secondary outcomes were patient satisfaction, work status, consumption of pain medication, the Major Depression Inventory (MDI), Pain Catastrophizing Scale (PCS) and quality of life (QoL) measured using the Short-Form Health Survey (SF-36). For each outcome measure, baseline data were compared to the latest collected data point. A significant pain relief was found with a mean reduction in NRS score of 2.4 (95% CI: 1.7-3.0, p<0.0001). 68.8% reported 'much improved' or 'very much improved' on the PGIC scale. 87.5% would choose SCS again for the same outcome. A significant beneficial impact was found on MDI score, PCS, SF-36 summary scores and consumption of tricyclic antidepressants, antiepileptic drugs and opioids. No statistical effect was found on work status. Pain intensity, depression, pain catastrophizing, pain medication use and QoL were significantly improved after SCS implantation, with high patient satisfaction rates in CRPS patients. This study supports the continued use of SCS in the treatment of severe CRPS. This study presents detailed data from a large, well-characterized cohort of Danish CRPS patients treated with SCS, analyzing several outcome measures. The results serve to document SCS as an effective treatment for severe CRPS and expands the cumulative level of evidence in favor of its use. Additionally, analysis of preoperative patient characteristics suggests that SCS treatment should not be withheld in patients with a high degree of psychological distress or high consumption of analgesics.

English

Over the last few years there has been a growing interest to cater to the requirements of children with special health care needs, especially those with autism spectrum disorder (ASD). ASD is a neurodevelopmental condition characterized by limited communication skills and an obsessive need for structured patterns. Individuals with a genetic predilection to autism can be provoked by the various prenatal, natal, or post-natal environmental factors. Drugs such as thalidomide, valproic acid and consumption of antidepressants during pregnancy as well as high maternal age and viral infections are known to be prenatal triggers for autism. Autism affects 1 in every 110 children with a significant preponderance of boys to girls with a ratio of 4:1. According to Caries Risk Assessment tool (CAT) adapted by the American Academy of Paediatric Dentistry, children with ASD are at a high risk for dental caries due to their preference for carious food, pouching of food due to poor masticatory ability combined with inadequate maintenance of oral hygiene and help required for tooth brushing. These children do not behave positively to sudden changes in their environment thus a dental operatory might be intimidating to them. A thorough understanding of the individual’s needs of these patients along with combining various behaviour management techniques will help make their dental treatment a pleasant one. This articles reviews literature on the aetiology and diagnosis of Autism Spectrum Disorder with a special emphasis on the health status and issues encountered while treating these children. This study is also an update on the various strategies such as using Applied Behaviour management approaches, Picture Exchange Communication System, Video Pedagogy, Social stories as well as pharmacological ways to communicate and also manage a child with ASD in the dental clinic. KEY WORDS Autism, Oral Health Status, Behaviour Management, Dental Management

Overview of antidepressants on the pharmaceutical market of Ukraine and dynamics of their consumption during 2015-2019

Among persistent health and disability disorders in Ukraine, the third place among men and the second among women are neuropsychiatric disorders, in the pharmacotherapy of which antidepressants are widely used.&#x0D; The aim of the work was to study the range and outpatient and hospital consumption of antidepressants in Ukraine.&#x0D; The analysis of the range and volume of antidepressant consumption was conducted in the outpatient market during 2015–2019 and in the hospital market during 2016–2019, according to the analytical company «Proxima Research»/«Morion». Consumption was calculated according to the ATC/DDD methodology. DDD/1 000 inhabitants per day (DID, DDD per 1 000 inhabitants per day) was used as a unit of measurement.&#x0D; The results of the study showed that in the pharmaceutical market of Ukraine during 2015–2019, 94–101 tons of antidepressants were used on an outpatient basis, including 29–36 tons of domestic production and 65 tons of foreign manufacturers. In 2016–2019, the hospital used a smaller number of antidepressants TH – 78–79 TH, including 27–29 TH of domestic production and 52–49 TH – imported. The number of trade names of antidepressants in outpatient consumption is 16–22% higher than the number of trade names in hospital consumption, which may be due to lower government procurement of drugs in this group. It was found that outpatient consumption of antidepressants in the period 2015–2019 increased 2.22 times – from 1.08 DID in 2015 to 2.40 DID in 2019. Consumption in hospitals was much lower and ranged from 0.20 DID in 2016. Up to 0.19 DID in 2019 (With a peak of 0.24 DID in 2017). The increase in the use of outpatient antidepressants was gradual, without abrupt changes. Most INN antidepressants, with the exception of N06AX20 Various drugs and the herb St. John's wort N06AX25, have been included in modern medical and technological documents: the State State form of drugs (8–11 issues) and the List of domestic and foreign drugs that can be purchased by health facilities, which are fully or partially funded from the state and local budgets (2015–2017), which indicates their proven clinical efficacy and safety.

Effects of the Antidepressants Citalopram and Venlafaxine on the Big Ramshorn Snail (Planorbarius corneus)

Depression is a serious health issue and, being such, treatment for it has become a topic of increasing concern. Consequently, the prescription rates of antidepressants have increased by about 50% over the past decade. Among antidepressants, citalopram and venlafaxine are the most frequently prescribed in Germany. Due to the high consumption and low elimination rates of both antidepressants during wastewater purification, they are frequently found in surface waters, where they may pose a risk to the aquatic environment. For the present study, we conducted experiments with the big ramshorn snail, which we exposed to environmentally relevant and explicitly higher concentrations (1–1000 µg/L) of the antidepressants citalopram and venlafaxine. We investigated apical endpoints, such as weight, mortality, behavioural changes, B-esterase activity, Hsp70 stress protein level and superoxide dismutase activity, as well as the tissue integrity of the hepatopancreas in the exposed snails. Citalopram and venlafaxine had no effects on the B-esterase activity, Hsp70 level and superoxide dismutase activity. Citalopram exposure resulted in weight reduction and tissue reactions in the hepatopancreas of snails exposed to 1000 µg/L. In contrast, venlafaxine did not induce comparable effects, but impacted the behaviour (sole detachment) of snails exposed to 100 µg/L and 1000 µg/L of the antidepressant. These results revealed that venlafaxine can affect snails at concentrations 10 times lower than citalopram. For this, in 2020 venlafaxine was introduced in the “Surface Water Watch List”, a list of potential pollutants that should be carefully monitored in surface water by the EU Member States.

Making Sense of Life-History Effects of the Antidepressant Citalopram in the Copepod Nitocra spinipes Using a Bioenergetics Model.

The global consumption of human antidepressants has steadily increased over the last years. The most widely prescribed antidepressants are the selective serotonin reuptake inhibitors (SSRIs), which have been linked to various life-history effects in nontarget organisms. We investigated the effects of the SSRI citalopram hydrobromide on the life history of the copepod Nitocra spinipes. Slight but significant developmental delay effects were observed at nominal concentrations of 0.1 and 1 µg/L, with stronger effects occurring at measured concentrations of 178 µg/L and above. At 77 µg/L and above, a significant increase in adult body length and offspring production/brood was found, although the time between brood releases remained unaffected. The pre-adult surviving fraction was significantly reduced (by 44%) at 765 µg/L. For a mechanistic evaluation of these observations, we used a bioenergetics model for N. spinipes based on the dynamic energy budget theory. Toxicokinetic and toxicodynamic submodels were used to dynamically simulate the chemical uptake and elimination, as well as dose-response relationships for hypothetical physiological modes of action and survival over time. Although none of the commonly invoked physiological modes of action, acting on assimilation, maintenance, growth, or offspring production, could explain the observed combination of effects, a newly proposed physiological mode of action acting on the process of maturation delivered correct predictions in terms of each effect's direction. The model fits could be further improved by allowing for a gentler concentration-effect slope and by adding an auxiliary physiological mode of action acting on the reproduction efficiency. The quantitative explanations provided in the present study offer a starting point for exploratory simulation studies investigating the effects of SSRIs at higher ecological levels. Environ Toxicol Chem 2021;40:1928-1939. © 2021 SETAC.

Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.

Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.

Association between xerostomia, oral and general health, and obesity in adults. A cross-sectional pilot study

Background The objective of this study was to analyse the association between oral and general health variables and obesity indicators with the sensation of dry mouth or xerostomia as evaluated on the Xerostomia Inventory (XI).Material and Methods A total of 354 randomly selected subjects participated in this cross-sectional pilot study and completed an anonymous questionnaire. Anthropometric, clinical, and xerostomic variables were evaluated. Kruskal-Wallis, ANOVA and Bonferroni test were used for multiple comparisons. ROC curves and multinomial logistic regression were used to determine the (OR) risk of xerostomia.Results A total of 30.7 % of respondents reported xerostomia based on XI. The dry mouth question, the XI taken as a “gold standard”, showed a diagnostic sensitivity of 70.37 %, and a specificity of 83.27 % (AUC=0.768, p<0.001). Logistical regression showed the highest xerostomia OR was associated to patients with bad self-perceived health, 6.31 (CI 95% 2.89-13.80, p<0.001). In the model adjusted for tooth mobility, bone or respiratory diseases, and the consumption of anxiolytics and antidepressants, the OR was 3.46 (CI 95% 1.47-8.18, p=0.005).Conclusions a high prevalence of xerostomia was found in this cross-sectional pilot study, which was significantly more frequent in women, and increased with age. Xerostomia was associated to several systemic diseases, psychological conditions, and oral functional disorders such as tooth mobility.These preliminary results can serve as the basis for developing guidelines for the application of innovative measures designed to improve the quality of life of individuals with xerostomia. Key words:Xerostomia, systemic pathology, oral health, obesity, geriatrics.

High Resolution Mass Spectrometry Analysis of the Sertraline Residues Contained in the Tissues of Rainbow Trout Reared in Model Experimental Conditions

The growing consumption of pharmaceuticals in the human population and the insufficient efficiency of their elimination in waste water has a long-term negative impact on the environment of aquatic ecosystems, including the organisms that inhabit them. A significant contributor is the consumption of anti-depressants from the SSRI group, which corresponds to their increasing concentration in the environment. The aim of this work was to determine if antidepressant sertraline is able to be stored in fish organisms and to evaluate the content of residues in various body tissues. Rainbow trout (Oncorhynchuss mykkis) was selected as the test organism and was artificially exposed to the antidepressant for 1 month (concentrations 0; 4.2; 44 and 400 ng.g-1 sertraline in the feed). Liver, kidney, brain and muscle tissue biopsies samples were taken for analysis. Detection was performed using an Accela 1250 LC pump and an Accela autosampler coupled with a high-performance mass analyzer with a heated electrospray ionization source Q-Exactive Orbitrap, operating in positive ionization mode and in PRM mode (m/z 306.08108->275.03888 and 309.009991->275.03888 for sertraline and internal standard, respectively). The limit of quantification of the method was 0.1 ng.g-1 of sertraline and the calibration curve showed a good linearity up to 20 ng.g-1. From the collected data, amount of residues was found in the liver, kidney and brain. In contrast, the incidence of residues in muscle tissue was not detected in all groups, which is favorable from the point of view of fish meat consumption, by humans.

PMH28 Antidepressant Consumption in Turkey between 2015-2017: Panel DATA Analysis

Antidepressants are one of the most prescribed and therefore the most used types of drugs. This study aims to find out the reasons for antidepressants use and their effects per person in Turkey. The sample panel data from 2015 to 2017 were used in this study covering 60 provinces of Turkey. The drug data was taken from IQVIA Turkey and the use per person was calculated in proportion to the population. Per capita physician application data were obtained from the Statistical Yearbook of the Ministry of Health Of Turkey and the data on population and Gross Domestic Product per capita were obtained from the Turkish Statistical Institute. A panel data regression model has been conducted and analysed. The model concluded that 99.25% of the variation in antidepressant consumption per person (box-based) is a dependent variable. However, the consumption of antidepressants per person, consultations with a physician per person, and the general population have significant effects. Therefore, when the other variables are kept constant and the total population increases by 1%, the coefficient of antidepressant use per capita increases by %0,62. With a similar interpretation, the number of antidepressants per capita increased slightly. According to the antidepressant use potential of the provinces, it is seen that the majority of the provinces tend to consume, reached, and even exceeded the potential level. Turkey's general population illustrates the growing trend of the elderly population. Considering that %0.62 drug use increases with each 1% population increase, the share of drug use in treating depression will increase health expenditures. It is necessary to make more specific researches on the subject, determine whether there is unnecessary use and what the alternative treatment costs are, and make the economic analysis.

The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients.

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

Political depression? A big-data, multimethod investigation of Americans' emotional response to the Trump presidency.

Previous studies suggested that the 2016 presidential elections gave rise to pathological levels of election-related distress in liberal Americans; however, it has also been suggested that the public discourse and the professional discourse have increasingly overgeneralized concepts of trauma and psychopathology. In light of this, in the current research, we utilized an array of big data measures and asked whether a political loss in a participatory democracy can indeed lead to psychopathology. We observed that liberals report being more depressed when asked directly about the effects of the election; however, more indirect measures show a short-lived or nonexistent effect. We examined self-report measures of clinical depression with and without a reference to the election (Studies 1A & 1B), analyzed Twitter discourse and measured users' levels of depression using a machine-learning-based model (Study 2), conducted time-series analysis of depression-related search behavior on Google (Study 3), examined the proportion of antidepressants consumption in Medicaid data (Study 4), and analyzed daily surveys of hundreds of thousands of Americans (Study 5), and saw that at the aggregate level, empirical data reject the accounts of "Trump Depression." We discuss possible interpretations of the discrepancies between the direct and indirect measures. The current investigation demonstrates how big-data sources can provide an unprecedented view of the psychological consequences of political events and sheds light on the complex relationship between the political and the personal spheres. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Utilization of the Parenteral Morphine in Emergency Department using the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD) System.

Objective:To evaluate the utilization of the parenteral morphine in Emergency Department (ED) using the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD) system.Methods:In this retrospective cross-sectional study, morphine administration was recorded in 4-year time period from January 2013 to December 2016 in the ED of a referral center. The dose of the administered morphine was evaluated using the ATC/DDD system. The ATC/DDD of the parenteral morphine was calculated based on the world health organization (WHO). The data was evaluated based on the different diagnosis and conditions using the ATC/DDD protocol. Results:In this study, 500 patients referred to ED with mean age of 48.29 ± 10.10 years were included. There were 306 (61.2%) men and 194 (38.8%) women among the patients. The lowest and highest DDD of parenteral morphine were 0.1 and 0.43, respectively. The utilization of parenteral morphine was significantly higher in men when compared to women (p<0.001). Those with history of tricyclic anti-depressant (TCA) consumption (p<0.001) and opium addiction (p<0.001) had significantly higher parenteral morphine utilization. Those with pain in the extremities and chest pain had significantly higher parenteral morphine utilization (p<0.001).Conclusion:The utilization of parenteral morphine in the ED of our center was higher than the WHO standard dosage. The morphine utilization was associated with male gender, opium addiction and TCA consumption.

Survival and factors predicting mortality after major and minor lower-extremity amputations among patients with diabetes: a population-based study using health information systems

IntroductionThe aim of the study was to identify the sociodemographic and clinical factors associated with death after the first lower-extremity amputation (LEA), minor and major separately, using data from regional...

Repeated bullying at the workplace in medical students and young doctors: the MESSIAEN national study.

Despite clues indicating high Bullying at the Work Place (BWP) rates in French hospitals, there has been no quantitative study so far. To determine the prevalence of repeated BWP in a national sample of French young physicians; its risk factors, and the mental health consequences of BWP. The study is a cross-sectional observational epidemiological national study addressed to young physicians. The online internet anonymous questionnaire was elaborated according to previous studies exploring BWP. In addition, we explored the quality of initial training. BWP was defined according to the French legal definition. Mental health was assessed by Hamilton Anxiety and Depression scale, psychotropic drug consumption and psychotherapy follow-up. A Structured Equation Modeling (SEM) was carried out to confirm our theoretical model. 2003 participants of the 37 French medical faculties were included. At least one history of BWP was identified in 41.7% of the participants. The SEM model showed good fit (RMSEA = 0.025, CFI = 0.93, TLI = 0.92, WRMR = 1.285). In the SEM model, BWP was associated with age and number of monthly night shifts and weekly worked hours. Obstetric gynecology, psychiatry, surgery, and medical specialties and low-quality initial training were associated with higher risk of BWP. BWP was associated with increased anxiety and depressive symptoms, daily antidepressant and anxiolytic consumption, and psychotherapy follow-up. Decreasing worked hours and night shifts and improving the quality of the initial training may help preventing BWP among medical students and young physicians. Obstetric gynecology, surgical and medical specialties, and psychiatry should be targeted with a focus on developing prevention programs.

Prevalence and Determinants of Long-Term Utilization of Antidepressant Drugs: A Retrospective Cohort Study.

PurposeAntidepressant consumption has risen in recent years, driven by longer treatment duration. The objective of this study was to measure the prevalence of antidepressant long-term and chronic use in the Bologna area, Italy, and to identify their main determinants.Materials and MethodsWe conducted a retrospective claims-based cohort study by using the Bologna Local Health Authority data. A cohort of 18,307 incident users of antidepressant drugs in 2013 was selected, and subjects were followed for three years. A long-term utilization was defined as having at least one prescription claimed during each year of follow-up, while chronic utilization was defined as claiming at least 180 defined daily doses per year. Factors associated with chronic and long-term use were identified by univariate and multivariate logistic regressions.ResultsIn our cohort, 5448 (29.8%) and 1817 (9.9%) subjects were dispensed antidepressants for a long-term course and in a chronically way, respectively. Older age, antidepressant polytherapy, polypharmacy, and being prescribed the first antidepressant by a hospital physician were all factors independently associated with chronic and long-term prescriptions of antidepressant drugs. Results were reported separately for men and women.ConclusionAntidepressant long-term and chronic prescriptions are common in the Bologna area. Because longer treatment should be clinically motivated, these results strongly prompt the need to evaluate the actual relevance, as they may indicate potentially inappropriate prescription patterns.