How do general practitioners select antidepressants for depressed elderly people?
This study aimed to identify factors predicting general practitioner's (GPs) choice of which antidepressant to prescribe for depression in the elderly, using a postal questionnaire survey based on three clinical case vignettes. The main outcome measure was the GP's primary reason for selection of an antidepressant. GPs prescribing SSRIs gave 'few side effects' and 'safer in overdose' as the most important reasons for choosing the antidepressant. Older GPs were more likely to use unmodified tricyclics, and selected drugs based on their knowledge and experience in use of the drug. Cost was rarely a primary consideration. Educational programmes should address the reluctance by some GPs to use new or unfamiliar medications and highlight issues relating to side-effects and drug safety.
Academic Unit of Psychiatry of Old Age, St Charles Hospital, London, UK. r.e.butler@ic.ac.uk
R
R
Butler
E
E
Collins
C
C
Katona
M
M
Orrell
D000328:Adult; D000367:Age Factors; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D002755:Choice Behavior; D003863:Depression / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D006113:United Kingdom
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors