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Self-reported indications for antidepressant use in a population-based cohort of middle-aged and elderly.
- Source :
-
International journal of clinical pharmacy [Int J Clin Pharm] 2016 Oct; Vol. 38 (5), pp. 1311-7. Date of Electronic Publication: 2016 Sep 01. - Publication Year :
- 2016
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Abstract
- Background Population-based studies investigating indications for antidepressant prescribing mostly rely on diagnoses from general practitioners. However, diagnostic codes might be incomplete and drugs may be prescribed 'off-label' for indications not investigated in clinical trials. Objective We aimed to study indications for antidepressant use based on self-report. Also, we studied the presence of depressive symptoms associated with the self-reported indications. Setting Our study population of antidepressant users was selected based on interview data between 1997 and 2013 from the prospective population-based Rotterdam Study cohort (age >45 years). Method Antidepressant use, self-reported indication for use, and presence of depressive symptoms (Center for Epidemiological Studies Depression Scale) were based on interview. Self-reported indications were categorized by the researchers into officially approved, clinically-accepted and commonly mentioned off-label indications. Main outcome measures A score of 16 and higher on the Center for Epidemiological Studies Depression Scale was considered as indicator for clinically-relevant depressive symptoms. Results The majority of 914 antidepressant users reported 'depression' (52.4 %) as indication for treatment. Furthermore, anxiety, stress and sleep disorders were reported in selective serotonin reuptake inhibitor and other antidepressant users (ranging from 5.9 to 13.3 %). The indication 'pain' was commonly mentioned by tricyclic antidepressant users (19.0 %). Indications were statistically significantly associated with higher depressive symptom scores when compared to non-users (n = 10,979). Conclusions Depression was the main indication for antidepressant treatment. However, our findings suggest that antidepressants are also used for off-label indications, subthreshold disorders and complex situations, which were all associated with clinically-relevant depressive symptoms in the middle-aged and elderly population.<br />Competing Interests: All authors declare to have no conflict of interest.
- Subjects :
- Aged
Aged, 80 and over
Anxiety epidemiology
Cohort Studies
Depressive Disorder epidemiology
Female
Humans
Male
Middle Aged
Netherlands epidemiology
Prospective Studies
Antidepressive Agents therapeutic use
Anxiety drug therapy
Depressive Disorder drug therapy
Population Surveillance methods
Self Report
Subjects
Details
- Language :
- English
- ISSN :
- 2210-7711
- Volume :
- 38
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of clinical pharmacy
- Publication Type :
- Academic Journal
- Accession number :
- 27586370
- Full Text :
- https://doi.org/10.1007/s11096-016-0371-9