title: Antidepressant Prescription Pattern in the Presence of Medical Co-morbidity: REAP-AD 2013 Study.
abstract: OBJECTIVE
  To evaluate the prescription pattern of antidepressants in patients with medical co-morbidity from major psychiatric centres in Asia.
  
  
  METHODS
  The Research on Asian Psychotropic Prescription Pattern for Antidepressants (REAP-AD 2013) collected data from 42 psychiatric centres in 10 Asian countries and regions. Antidepressant prescriptions of 2320 patients with various psychiatric disorders were evaluated. Of these, 370 patients who had specified medical co-morbidities formed the study cohort.
  
  
  RESULTS
  Escitalopram (20%) and mirtazapine (20%) were the most commonly prescribed antidepressants in patients with medical co-morbidity followed by sertraline (16%), trazodone (15%), and paroxetine (12%). Overall, more than half (52%; 247/476) of prescriptions comprised selective serotonin reuptake inhibitors. Slightly less than two-thirds (63%; n = 233) of patients received at least 1 selective serotonin reuptake inhibitor. In addition, 79% of patients were prescribed only 1 antidepressant. The mean number of antidepressants used per patient was 1.25 (standard deviation, 0.56). There were subtle differences in the most preferred antidepressant across medical illnesses such as diabetes mellitus, liver dysfunction, acid peptic disease, and cerebrovascular disease. Differences were also seen in prescription patterns across different countries.
  
  
  CONCLUSIONS
  Although selective serotonin reuptake inhibitors formed the bulk of antidepressant prescriptions in the presence of medical co-morbidity, mirtazapine was also commonly used in the presence of medical co-morbidities. Specified medical morbidities do influence the selection of antidepressants.
authors.affiliation: Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Grover
authors.affiliation: Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: A
authors.initials: A
authors.lastname: Avasthi
authors.affiliation: Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India.
authors.forename: A
authors.initials: A
authors.lastname: Tripathi
authors.affiliation: Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Sulawesi Selatan, Indonesia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Tanra
authors.affiliation: Department of Psychiatry and Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
authors.forename: K Y
authors.initials: KY
authors.lastname: Chee
authors.affiliation: Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, PR China.
authors.forename: Y L
authors.initials: YL
authors.lastname: He
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
authors.forename: H Fk
authors.initials: HF
authors.lastname: Chiu
authors.affiliation: Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kuga
authors.affiliation: Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea.
authors.forename: M S
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan.
authors.forename: M Y
authors.initials: MY
authors.lastname: Chong
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Udormatn
authors.affiliation: Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kanba
authors.affiliation: Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan.
authors.forename: S Y
authors.initials: SY
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, Peking University Institute of Mental Health, Beijing, PR China.
authors.forename: T M
authors.initials: TM
authors.lastname: Si
authors.affiliation: Institute of Mental Health, Buangkok View, Buangkok Green Medical Park Singapore, Taipei, Taiwan.
authors.forename: K
authors.initials: K
authors.lastname: Sim
authors.affiliation: Department of Pharmacology, National University of Singapore, Singapore.
authors.forename: C H
authors.initials: CH
authors.lastname: Tan
authors.affiliation: Department of Psychiatry, TMU-Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: W W
authors.initials: WW
authors.lastname: Shen
authors.affiliation: Faculty of Health Sciences, University of Macau, Macao SAR, PR China.
authors.forename: Y T
authors.initials: YT
authors.lastname: Xiang
authors.affiliation: Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Sartorius
authors.affiliation: Department of Psychiatry, Kobe University, Kobe, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Shinfuku
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001208:Asia; D002648:Child; D015283:Citalopram / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy*; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D008803:Mianserin; D000078785:Mirtazapine; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Antidepressive agents; Asia; Comorbidity