The treatment of depression in UK general practice: selective serotonin reuptake inhibitors and tricyclic antidepressants compared.
BACKGROUND
Antidepressants are commonly prescribed by general practitioners as treatment for depression. Controversy exists as to the effectiveness in everyday use of the older tricyclic antidepressants (TCAs) when compared to the newer selective serotonin reuptake inhibitors (SSRIs).


OBJECTIVE
To investigate the patterns of current prescribing of antidepressants for the treatment of depression and compare TCAs with the newer SSRIs.


METHODS
The study population was patients attending 151 computerised general practices from throughout the United Kingdom between 1991 and 1996. Patients with new prescriptions for antidepressants and a diagnosis of depression were identified. Age and gender distributions, prescribed doses and drop-out rates were investigated.


RESULTS
During the study period 9.8% of patients received a prescription for an antidepressant, there was a 40% increase in the prescribing rate of TCAs and a 460% increase in SSRI prescribing. TCAs were initially prescribed in sub-therapeutic doses. More than 50% of patients ceased taking their antidepressants within 6 weeks of starting treatment. Fluoxetine and paroxetine were more likely to be prescribed for a therapeutic period than were other antidepressants.


CONCLUSIONS
General practitioners should prescribe a therapeutic dose of antidepressant for a recognised therapeutic period to ensure that patients with depression receive the most effective treatment.
Lawrenson
R A
RA
European Institute of Health and Medical Sciences, University of Surrey, Surrey GU2 5RF, Guildford, UK. r.lawrenson@surrey.ac.uk
Tyrer
F
F
Newson
R B
RB
Farmer
R D
RD
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy*; D004363:Drug Utilization; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D010352:Patient Dropouts; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012737:Sex Factors; D006113:United Kingdom
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors