European Journal of Clinical Pharmacology

, Volume 69, Issue 2, pp 227–236 | Cite as

A nationwide prospective study on prescribing pattern of antidepressant drugs in Italian primary care

  • Gianluca Trifirò
  • Silvia Tillati
  • Edoardo Spina
  • Carmen Ferrajolo
  • Marianna Alacqua
  • Eugenio Aguglia
  • Laura Rizzi
  • Achille P. Caputi
  • Claudio Cricelli
  • Fabio Samani
Pharmacoepidemiology and Prescription



Our purpose was to explore antidepressant drug (AD) prescribing patterns in Italian primary care.


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.


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.


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.


General practice Antidepressives Pharmacoepidemiology Italy 



This study was funded by the Italian Drug Agency through a national grant dedicated to pharmacovigilance projects.

Conflict of interest



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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Gianluca Trifirò
    • 1
  • Silvia Tillati
    • 2
  • Edoardo Spina
    • 1
  • Carmen Ferrajolo
    • 3
  • Marianna Alacqua
    • 1
  • Eugenio Aguglia
    • 4
  • Laura Rizzi
    • 2
  • Achille P. Caputi
    • 1
  • Claudio Cricelli
    • 5
  • Fabio Samani
    • 6
  1. 1.Department of Clinical and Experimental Medicine and PharmacologyUniversity of MessinaMessinaItaly
  2. 2.Department of Economic and Statistical SciencesUniversity of UdineUdineItaly
  3. 3.Pharmacovigilance and Pharmacoepidemiology Regional Center, Department of Experimental Medicine, Pharmacology SectionSecond University of NaplesNaplesItaly
  4. 4.Department of Clinical and Molecular BiomedicineUniversity of CataniaCataniaItaly
  5. 5.Italian College of General PractitionersFlorenceItaly
  6. 6.Local Health Unit of TriesteTriesteItaly

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