A nationwide prospective study on prescribing pattern of antidepressant drugs in Italian primary care.
OBJECTIVE
Our purpose was to explore antidepressant drug (AD) prescribing patterns in Italian primary care.


METHODS
Overall, 276 Italian general practitioners (GPs) participated in this prospective study, recruiting patients >18 years who started AD therapy during the enrolment period (January 2007 to June 2008). During visits at baseline and 3, 6, and 12 months, data about patients' characteristics and AD treatments were collected by the GPs. Discontinuation rate among new users of AD classes [i.e., selective serotonin reuptake inhibitors (SSRI); tricyclics (TCAs); other ADs) were compared. Logistic regression analyses were performed to identify predictors of AD discontinuation.


RESULTS
SSRIs were the most frequently prescribed ADs (N = 1,037; 75.3 %), especially paroxetine and escitalopram. SSRIs were more likely to be prescribed because of depressive disorders (80 %), and by GPs (51.1 %) rather than psychiatrists (31.8 %). Overall, 27.5 % (N = 378) of AD users discontinued therapy during the first year, mostly in the first 3 months (N = 242; 17.6 %), whereas 185 (13.4 %) were lost to follow-up. SSRI users showed the highest discontinuation rate (29 %). In patients with depressive disorders, younger age, psychiatrist-based diagnosis, and treatment started by GPs were independent predictors of SSRI discontinuation.


CONCLUSIONS
In Italy, ADs-especially SSRIs-are widely prescribed by GPs because of depressive/anxiety disorders. Active monitoring of AD users in general practice might reduce the AD discontinuation rate.
Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Via Consolare Valeria Gazzi, 98125 Messina, Italy. trifirog@unime.it
Gianluca
G
Trifirò
Silvia
S
Tillati
Edoardo
E
Spina
Carmen
C
Ferrajolo
Marianna
M
Alacqua
Eugenio
E
Aguglia
Laura
L
Rizzi
Achille P
AP
Caputi
Claudio
C
Cricelli
Fabio
F
Samani
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D055815:Young Adult
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors