Antidepressant use patterns in clinical practices: comparisons among tricyclic antidepressants and selective serotonin reuptake inhibitors.
OBJECTIVE
Antidepressant use in clinical practice may differ from that in randomized controlled trials due to the complex interaction between patients, prescribers and the health-care system.


METHODS
A review of studies using data from actual clinical practice has found consistent differences in the prescribing patterns of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).


RESULTS
Patients who initiate therapy on SSRIs are more likely to complete a course of adequate dose and duration of antidepressant therapy than patients who initiate therapy on a TCA. Differences in prescribing patterns have also emerged among the most common SSRIs, fluoxetine, sertraline and paroxetine, that are also consistent over time, settings and countries.


CONCLUSIONS
Given that the drugs studied are one constant across all the studies, the antidepressants' underlying pharmacological differences in tolerability and other properties may provide an explanation for differences in prescribing patterns.
Donoghue
J
J
School of Pharmacy and Chemistry, Liverpool John Moores University, UK.
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004361:Drug Tolerance; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors