Newer antidepressant drug use in East Asian psychiatric treatment settings: REAP (Research on East Asia Psychotropic Prescriptions) Study.
OBJECTIVE
Antidepressant use in East Asia is poorly documented. We compared patients given newer and older antidepressants to test the hypothesis, suggested in the literature, that use of newer antidepressants is associated with treatment settings rather than specific diagnostic categories.


METHODS
We compared rates of use of older (pre1990) vs. newer antidepressants among 1898 patients identified as antidepressant treated at 21 centres in five East Asian countries (China, Japan, Korea, Singapore, Taiwan) in 2003. Demographics, treatment setting and clinical factors associated with preferential use of newer drugs were tested in univariate and multivariate analyses.


RESULTS
Newer antidepressants were included in the treatment regimens of 67.5% (N = 1282/1898) of study subjects. Prescription for newer antidepressants was significantly associated with younger age (z = -4.55, d.f. = 1888, P < 0.001), hospitalization [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.07, 1.64, P < 0.01] and treatment within psychiatric hospitals (OR 1.59, 95% CI 1.27, 2.00, P < 0.001). On multivariate analyses, treatment with newer antidepressants was independently associated with younger age (P < 0.001), country (P < 0.001) and treatment within private hospitals (P < 0.001), but not with sex or diagnosis of affective or anxiety disorders (all P > 0.1).


CONCLUSIONS
Demographic factors and treatment settings appear to influence antidepressant choice more than clinical factors such as diagnosis.
Sim
Kang
K
Institute of Mental Health/Woodbridge Hospital, Singapore. kang_sim@imh.com.sg
Lee
N B
NB
Chua
Hong C
HC
Mahendran
Rathi
R
Fujii
Senta
S
Yang
Shu-Yu
SY
Chong
Mian-Yoon
MY
Si
Tianmei
T
He
Yan L
YL
Lee
Min S
MS
Sung
Kil M
KM
Chung
Eun K
EK
Chan
Yiong H
YH
Shinfuku
Naotaka
N
Tan
Chay H
CH
Sartorius
Norman
N
Baldessarini
Ross J
RJ
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001208:Asia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003710:Demography; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors