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Pharmacy World and Science

, Volume 23, Issue 2, pp 46–49 | Cite as

Antidepressant prescription for depression in general practice in the Netherlands

  • Harm.W.J. van marwijk
  • Dick Bijl
  • Herman J. Adegrave;r
  • Marten de Haan
Article

Abstract

Objective: To evaluate diagnoses and the prescription of antidepressants drugs for depression, based on data from 1993 to 1998 related to consultations for depression in general practice in the Netherlands. Method: An exploratory analysis of data provided by IMS Health. Consecutive annual representative samples of 640 GPs regularly registered data on morbidity and (drug) treatment for specific medical problems in special booklets for a period of one week. The data refer to consultations for depression. The diagnoses were initially based on ICD‐9 criteria and later ICD‐10 criteria for depression.Main outcome measures: Number of diagnoses of depression and number of prescriptions for antidepressants.Results: The number of first consultations for depression rose gradually, from 909 in 1993 (95% CI: 774 to 1043), to 1,482 (CI: 1292 to 1672) in 1998: an increase of 63%. For an individual GP, this represents an increase from 18 to 30 in first consultations for depression. The number of prescriptions for antidepressants also increased, mainly during repeat consultations: a 278% increase, from 3,708 in 1993 to 14,024 in 1998 (CIs: 3,504 to 3,912 and 13,252 to 14,796). Antidepressants were prescribed during the first consultation 564 times in 1993 compared with 1,080 times in 1998. The first contact with a GP for depression led to an antidepressant prescription in 62% of cases in 1993 and 73% in 1998. Although the guidelines issued by the Dutch College of General Practitioners in 1994 recommended tricyclic antidepressants (TCAs) for the treatment of depression, paroxetin, fluoxetin, and mirtazapin (SSRIs) accounted for 56% of the prescribed antidepressants.Conclusion:Between 1993 and 1998, GPs in the Netherlands prescribed increasingly more antidepressants, and they prescribed more SSRIs than TCAs. Furthermore, GPs diagnose depression more frequently and the number of repeat consultations has increased.

Aantidepressant drugs Consultations Depression General practice Prescriptions 

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References

  1. 1.
    Van Marwijk HWJ, Grundmeijer HGLM, Brueren MM, et al. Dutch College of General Practitioners guidelines on depression [In Dutch]. Huisarts Wet 1994;37:482-90.Google Scholar
  2. 2.
    De Groot PA. Consensus on depression in adults [In Dutch, with English summary]. Ned Tijdschr Geneeskd 1995; 139:1237-41.Google Scholar
  3. 3.
    Van der Kuy A (ed.). Dutch Pharmacotherapeutic Manual 1999 [in Dutch]. Amstelveen: Ziekenfondsraad: 1999.Google Scholar
  4. 4.
    Hoes MJAJM. Antidepressants: is new better? Gebu (Dutch Drug Bulletin) 1995;29:103-8.Google Scholar
  5. 5.
    Geddes JR, Freemantle N, Mason J, et al. SSRIs versus other antidepressants for depressive disorder (Cochrane Review). In: The Cochrane Library, Issue 2, 2000. Oxford: Update Software.Google Scholar
  6. 6.
    Williams JW, Mulrow CD, Chiquette E, et al. A systematic review of newer pharmacotherapies for depression in adults: evidence report summary. Ann Int Med 2000;132:743-56.Google Scholar
  7. 7.
    De Waal MWM, Stolk J, Van Marwijk HWJ, et al. Prescription of antidepressants in family practice [In Dutch, with English summary]. Ned Tijdschr Geneeskd 1996;140:2131-4.Google Scholar
  8. 8.
    Veeninga AT, van Rijn OJL, Burgers JS. Prescribing antidepressants in general practice [In Dutch]. Huisarts Wet 1999; 42:112-4.Google Scholar
  9. 9.
    Egberts ACG, Veenstra M, De Jong-Van den Berg LTW. Antidepressant drug choice for first users in two regions in the Netherlands. Pharm World Sci 1999; 21:132-6.Google Scholar
  10. 10.
    Complementary audit data. Medische index Nederland. 's Gravenhage: IMS Nederland BV, 1996.Google Scholar
  11. 11.
    International Statistical Classification of Diseases, Wounds and Death causes. 9th revision. WHO: Geneva, 1975.Google Scholar
  12. 12.
    Bijl D, Van Dam LFT, Van Marwijk HWJ, et al. Treatment of depression and comorbid anxiety [In Dutch]. DIMS 1999 (34):9-13.Google Scholar
  13. 13.
    Bland MJ, Altman DG. Statistics with confidence. London: British Medical Journal, 1989.Google Scholar
  14. 14.
    Anonymous. Pharm Weekbl 1999;134:1199.Google Scholar
  15. 15.
    Ornstein S, Stuart G, Jenkins R. Depression diagnoses and antidepressant use in primary care practices: a study from the Practice Partner Research Network (PPRNet). J Fam Pract 2000;49:68-72.Google Scholar
  16. 16.
    Eccles M, Freemantle N, Mason J. North of England evidence-based guideline development project: summary version of guidelines for the choice of antidepressants for depression in primary care. North of England Antidepressant Guideline Development Group. Fam Pract 1999;16:103-11.Google Scholar
  17. 17.
    Lawrenson RA, Tyrer F, Newson RB, et al. The treatment of depression in UK general practice: selective serotonin reuptake inhibitors and tricyclic antidepressants compared. J Affect Disord 2000;59:149-57.Google Scholar
  18. 18.
    De Neeling JND. Fitting medical care, about choices and guidelines [In Dutch]. Den Haag: Health council of the Netherlands, 2000.Google Scholar
  19. 19.
    Rosholm JU, Gram LF, Damsbo N, et al. Antidepressant treatment in general practice-an interview study. Scand J Prim Health Care 1995;13:281-6.Google Scholar
  20. 20.
    Lima MS, Moncrieff J. A comparison of drugs versus placebo for the treatment of dysthymia (Cochrane Review). In: The Cochrane Library, Issue 2, 2000. Oxford: Update Software.Google Scholar
  21. 21.
    Trindade E, Menon D, Topfer LA, et al. Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. CMAJ 1998;159:1245-52.Google Scholar
  22. 22.
    Okkes IM, Oskam SK, Lamberts H. From complaint to diagnosis [In Dutch]. Bussum: Coutinho, 1998.Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Harm.W.J. van marwijk
    • 1
  • Dick Bijl
    • 1
  • Herman J. Adegrave;r
    • 1
  • Marten de Haan
    • 1
  1. 1.Department of General Practice and Department of Clinical Epidemiology and BiostaticsVrije UniversiteitAmsterdamThe Netherlands

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