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Antidepressant Prescription Pattern in the Presence of Medical Co-morbidity: REAP-AD 2013 Study

Grover S 1 , Avasthi A 1 , Tripathi A 2 , Tanra AJ 3 , Chee KY 4 , He YL 5 Show all authors , Chiu HF 6 , Kuga H 7 , Lee MS 8 , Chong MY 9 , Udormatn P 10 , Kanba S 7 , Yang SY 11 , Si TM 12 , Sim K 13 , Tan CH 14 , Shen WW 15 , Xiang YT 16 , Sartorius N 17 , Shinfuku N 18

Affiliations 

  • 1 Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • 2 Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India
  • 3 Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Sulawesi Selatan, Indonesia
  • 4 Department of Psychiatry and Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 5 Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, PR China
  • 6 Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
  • 7 Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
  • 8 Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
  • 9 Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan
  • 10 Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  • 11 Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
  • 12 Department of Psychiatry, Peking University Institute of Mental Health, Beijing, PR China
  • 13 Institute of Mental Health, Buangkok View, Buangkok Green Medical Park Singapore, Taipei, Taiwan
  • 14 Department of Pharmacology, National University of Singapore, Singapore
  • 15 Department of Psychiatry, TMU-Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan
  • 16 Faculty of Health Sciences, University of Macau, Macao SAR, PR China
  • 17 Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
  • 18 Department of Psychiatry, Kobe University, Kobe, Japan
East Asian Arch Psychiatry, 2015 Sep;25(3):99-107.
PMID: 26429836

Abstract

Objective: To evaluate the prescription pattern of antidepressants in patients with medical co-morbidity from major psychiatric centres in Asia.
Methods: The Research on Asian Psychotropic Prescription Pattern for Antidepressants (REAP-AD 2013) collected data from 42 psychiatric centres in 10 Asian countries and regions. Antidepressant prescriptions of 2320 patients with various psychiatric disorders were evaluated. Of these, 370 patients who had specified medical co-morbidities formed the study cohort.
Results: Escitalopram (20%) and mirtazapine (20%) were the most commonly prescribed antidepressants in patients with medical co-morbidity followed by sertraline (16%), trazodone (15%), and paroxetine (12%). Overall, more than half (52%; 247/476) of prescriptions comprised selective serotonin reuptake inhibitors. Slightly less than two-thirds (63%; n = 233) of patients received at least 1 selective serotonin reuptake inhibitor. In addition, 79% of patients were prescribed only 1 antidepressant. The mean number of antidepressants used per patient was 1.25 (standard deviation, 0.56). There were subtle differences in the most preferred antidepressant across medical illnesses such as diabetes mellitus, liver dysfunction, acid peptic disease, and cerebrovascular disease. Differences were also seen in prescription patterns across different countries.
Conclusion: Although selective serotonin reuptake inhibitors formed the bulk of antidepressant
prescriptions in the presence of medical co-morbidity, mirtazapine was also commonly used in the presence of medical co-morbidities. Specified medical morbidities do influence the selection of antidepressants.
Key words: Antidepressive agents; Asia; Comorbidity

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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