A Study of Antidepressant Prescription in Major Depressive Disorders in the Out-Patient Psychiatric Department of Siriraj Hospital

Abstract

Objective: This study is aimed to study antidepressant prescription in new cases of major depressive disorders in the Out-patient Psychiatric Department and to compare antidepressant prescription between staff and residents. Another reason was to study basic data of major depressive disorders such as incidence, response and follow - up patterns for further study.
Methods: A retrospective study of new cases of major depressive disorders who came to the Out-patient Psychiatric Department from April 2003 to September 2003 (6-month period). Personal data, treatment data, as well as result and follow - up data were collected. Data were analyzed in percentage and Chi-square.
Results: The incidence of major depressive disorders in the Out-patient Psychiatric Department was 5.9%. The subjects of the study consisted of 53 cases; the largest group was over 51 years old (41.5%), with females doubling the number males (66 % and 34%), most of whom were housewives (35.8%). The predominant diagnosis was major depressive disorder with no psychotic symptoms or sychosocial stress (81.1%). Selective serotonin reuptake inhibitors (SSRI) or new generation antidepressants were mainly prescribed (64.2%); most of the antidepressants were in the National Drug Prescription (71.7%). About 52.8% of patients had been prescribed one co-drug treatment and the most frequently prescribed was benzodiazepine. The major pattern of antidepressant prescription was a non-adjustment dose (41.5%). Antidepressants at the therapeutic period were mostly unchanged compared to the initial period (58.5%) and were in the National Drug Prescription (54.7%). There was no statistically significant difference between staff and residents in antidepressant prescription except that residents prescribed antidepressants in the National Drug Prescription at first visit and the therapeutic period with no side effects, unlike members of the staff, which was statistically significant (P < 0.001***; P < 0.01**; P < 0.05,* respectively).
Conclusion: The antidepressant prescription in the Out-patient Psychiatric Department commonly prescribed selective serotonin reuptake inhibitors (SSRI) or new generation antidepressants and non-adjustment doses. Residents prescribed more antidepressants in the National Drug Prescription than staff members were, which was statistically significant. This study found that the patients of residents did not continue follow-up after the first visit, a higher number than that of the staff (19.4%, 5.6%), further study should be considered.