Optimising Antidepressant Use in Clinical Practice: Considering External Factors.
- Author:
Byung Joo HAM
1
;
Chang Hwan HAN
Author Information
1. Department of Neuropsychiatry, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea. hambj@chol.com
- Publication Type:Original Article
- Keywords:
Depression;
Antidepressants;
Optimal treatment
- MeSH:
Antidepressive Agents;
Antidepressive Agents, Tricyclic;
Depression;
Health Care Costs;
Humans;
Public Health;
Serotonin
- From:Journal of Korean Neuropsychiatric Association
2008;47(1):22-27
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Depressive illness is a major public health problem with important medical, social and economic implications. The efficacy of various antidepressants in treating depression has been demonstrated in randomized controlled trials (RCTs). However, these studies do not adequately address the complexities of clinical practice. Although most of RCTs assumed there was no difference in efficacy between the tricyclic antidepressants (TCAs) and serotonin specific reuptake inhibitors (SSRIs), naturalistic studies show that patients who take TCAs often receive subtherapeutic doses for inadequate duration than those with SSRIs. Because the benefits of the implementation of current guidelines are limited, the optimal choice of medication must be guided by detailed history and careful consideration of the real-world efficacy of antidepressants and long-term health care costs.
