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

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

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.

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Acknowledgments

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

Conflict of interest

None

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Via Consolare Valeria Gazzi, 98125, Messina, Italy

    Gianluca Trifirò, Edoardo Spina, Marianna Alacqua & Achille P. Caputi

  2. Department of Economic and Statistical Sciences, University of Udine, Udine, Italy

    Silvia Tillati & Laura Rizzi

  3. Pharmacovigilance and Pharmacoepidemiology Regional Center, Department of Experimental Medicine, Pharmacology Section, Second University of Naples, Naples, Italy

    Carmen Ferrajolo

  4. Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy

    Eugenio Aguglia

  5. Italian College of General Practitioners, Florence, Italy

    Claudio Cricelli

  6. Local Health Unit of Trieste, Trieste, Italy

    Fabio Samani

Authors
  1. Gianluca Trifirò
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  2. Silvia Tillati
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  3. Edoardo Spina
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  4. Carmen Ferrajolo
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  5. Marianna Alacqua
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  6. Eugenio Aguglia
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  7. Laura Rizzi
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  8. Achille P. Caputi
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  9. Claudio Cricelli
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Corresponding author

Correspondence to Gianluca Trifirò.

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Trifirò, G., Tillati, S., Spina, E. et al. A nationwide prospective study on prescribing pattern of antidepressant drugs in Italian primary care. Eur J Clin Pharmacol 69, 227–236 (2013). https://doi.org/10.1007/s00228-012-1319-1

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  • DOI: https://doi.org/10.1007/s00228-012-1319-1

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