Antidepressants: psychiatrists' opinions and clinical practice.
OBJECTIVE
To describe and compare psychiatrists' opinion on antidepressant drugs and their prescriptions to depressed patients.


METHODS
Between January and September 1999 a representative sample of French psychiatrists was asked their opinion of the 15 most prescribed antidepressants, and then to describe the treatments of the current depressive episode of four depressive patients each, their changes and the reason thereof.


RESULTS
A total of 232 psychiatrists and 935 patients participated. The best ranked antidepressants were clomipramine, paroxetine and amitriptyline for efficacy, tianeptine, paroxetine and citalopram for tolerability. In patients, the most often prescribed were paroxetine, fluoxetine and venlafaxine. Those least often stopped for intolerance were tianeptine (2.9%), citalopram (5.2%), venlafaxine (3.3%) and amitriptyline (5.7%) for lack of efficacy. There was no difference in stopping rates for inefficacy of tricyclics and serotonin-selective agents.


CONCLUSIONS
The best predictors for the prescribed antidepressants were the psychiatrists' overall rankings and opinions of the tolerability of the drug.
Depont
F
F
Departments of Pharmacology and Adult Psychiatry, Public Health Research Institute IFR99, Université Victor Segalen, Bordeaux, France.
Rambelomanana
S
S
Le Puil
S
S
Begaud
B
B
Verdoux
H
H
Moore
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000145:classification / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011570:Psychiatry; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents