重性抑郁障碍
药方
萧条(经济学)
医学
回顾性队列研究
精神科
重性抑郁发作
社会心理的
抑郁症状
内科学
心理学
心情
认知
经济
药理学
宏观经济学
作者
Lucie Bartova,Gernot Fugger,Markus Dold,Alexander Kautzky,Giuseppe Fanelli,Raffaella Zanardi,Diego Albani,Ana Weidenauer,Dan Rujescu,Daniel Souery,Julien Mendlewic,Stuart Montgomery,Joseph Zohar,Chiara Fabbri,Alessandro Serretti,Siegfried Kasper
标识
DOI:10.1016/j.jad.2023.03.068
摘要
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are among the most frequently prescribed antidepressants (ADs) for major depressive disorder (MDD), with an increasing trend in the last decade. Given the relative dearth of information regarding rationales for their preferred use as first-line ADs in the broad clinical routine, the present study systematically investigated real-world characteristics of MDD patients prescribed either SNRIs or other AD substances across different countries and treatment settings.In the present secondary analyses based on a large European, multi-site, naturalistic and cross-sectional investigation with a retrospective assessment of treatment outcome, we firstly defined the proportion of MDD patients receiving SNRIs as first-line AD psychopharmacotherapy and secondly compared their sociodemographic and clinical characteristics to those patients prescribed alternative first-line ADs during their current major depressive episode (MDE).Within the total sample of 1410 MDD patients, 336 (23.8 %) received first-line SNRIs. Compared to other ADs, SNRIs were significantly associated with inpatient care, suicidality and treatment resistance during the current MDE, and a longer lifetime duration of psychiatric hospitalizations. Moreover, greater severity of depressive symptoms at study entry, higher daily doses of the administered ADs, as well as more frequent prescriptions of psychopharmacotherapeutic add-on strategies in general and antipsychotic augmentation in particular, were significantly related to first-line SNRIs.Considering the limitations of a cross-sectional and retrospective study design, our data point towards a preferred use of first-line SNRIs in a generally more severely ill MDD patients, although they did not lead to superior treatment outcomes compared to alternative ADs.
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