title: Selective serotonin reuptake inhibitors have broadened the utilisation of antidepressant treatment in accordance with recommendations. Findings from a Swedish prescription database.
abstract: BACKGROUND
  With the advent of the selective serotonin reuptake inhibitors (SSRIs), the use of antidepressants has increased drastically in Sweden. The use of tricyclic antidepressants (TCAs) has, however, decreased.
  
  
  METHODS
  We surveyed a prescription database in the Swedish county of Jämtland and compared prescription patterns for patients prescribed SSRIs with those prescribed TCAs.
  
  
  RESULTS
  The incidence of treatments of antidepressants increased from 0.76% to 1.33% during the period 1991-1996. There were no significant differences between SSRIs and TCAs with regard to patients having only one prescription dispensed within three months from the index prescription, or patients who switched class of antidepressant. Only a minority of the treatments were continued for at least six months, but significantly more SSRI than TCA treatments (42% and 27%). A second treatment period suggesting recurrence was three-times more common in the TCA group than in the SSRI group.
  
  
  CONCLUSIONS
  Provided that the increased use of SSRIs is mainly for depression, these drugs appear, despite a lower efficacy in severe depression, to have enabled a broader utilisation of antidepressants with regard to incidence, dosage and duration, in accordance with recommendations. Further analyses of this phenomenon relative to diagnostic criteria and outcome measures are required.
authors.affiliation: Department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Huddinge University Hospital, Sweden. Goran.Isacsson@cnsf.ki.se
authors.forename: G
authors.initials: G
authors.lastname: Isacsson
authors.forename: G
authors.initials: G
authors.lastname: Boëthius
authors.forename: S
authors.initials: S
authors.lastname: Henriksson
authors.forename: J K
authors.initials: JK
authors.lastname: Jones
authors.forename: U
authors.initials: U
authors.lastname: Bergman
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000191:economics / Q000627:therapeutic use*; D019992:Databases as Topic; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D016903:Drug Monitoring; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics / Q000627:therapeutic use*; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors