[Trends in pharmacotherapy of unipolar depression at the beginning of the century in Hungary].
At the first glance the treatment of depression not seems to be a difficult task for the physicians. However, prescribing an effective drug, determining the right dose and choosing a suitable adjunctive therapy are all important factors requiring up-to-date knowledge and experience by the physicians. The results of evidence based studies, experimental facts, and anecdotal knowledge are taken into practice by the physicians so it is of vital importance to gain information about the actual pharmacotherapeutic trends they use in everyday practice. Since these facts are rarely revealed, the aim of my study was to give an overview of the therapeutic trends of depression in Hungary.


METHODS
A questionnaire constructed by the author was filled in by psychiatrists working in outpatient clinics in different regions of Hungary for each patient turned to them in the period between 1 and 11 June, 2004. The inclusion criteria was the diagnosis of unipolar major depression and the exclusion criteria was the existing comorbid psychiatric disorder both based on the judgement of the clinician. Since neither the physician, nor the patient was identified the study was blind to the investigator.


RESULTS
By evaluating 170 questionnaires 20,6% of the patients were found to take one, 46,5% two, 24,7% three, and only 8,2% four or more kinds of psychotropic drugs simultaneously. Only 4 patients were not given any antidepressants at all and 19 (13,5%) were on two antidepressants. 64,1% of the patients took some SSRI (citalopram>sertraline>paroxetine), 22,4% some dual action (mirtazapine>venlafaxine), and 22,4 other antidepressants (tianeptine, moclobemid etc). Not any kind of classical TCS was given. 71,8% of the patients found to be on anxiolytic, 7,7% on mood stabilizer, 4,2 on antipsychotic and 16,5% on hypnotic drug. The doses used by clinicians did not show any deviation from the guidelines. 95 patients (55,9%) could be kept balanced with the therapy above and only 8 patients (4,7%) were in serious condition. More than half of the patients (54,1%) was given the same antidepressant for one year and the long term use of anxiolytics was found to be typical.


CONCLUSIONS
The results show the current trends in the pharmacological treatment of depression. Only psychiatrists participated in the study because mostly they have the responsibility for the correct diagnosis, assessment and therapeutic choice up to the present in Hungary. These data can be compared with the international trends, professional expectation, or the future results of trials and also can be used in education.
Kovács
Gábor
G
MH Központi Honvédkórház Pszichiátriai osztály, Budapest.
D000928:Antidepressive Agents / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D011570:Psychiatry / Q000706:statistics & numerical data; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D017367:Selective Serotonin Reuptake Inhibitors