J Mendlewicz1. 1. Department of Psychiatry, University of Brussels (Erasme Hospital), Route de Lennick 808, 1070 Brussels, Belgium. jmendlew@ulb.ac.be
Abstract
BACKGROUND: Current treatment for depression in primary care and other out-patient settings demonstrates a pattern that is incongruous with the magnitude of the burden of depression suggested by its associated disability. AIMS: To review important considerations in current depression treatment with a focus on antidepressant use. METHOD: Factors influencing the undertreatment of depression in real-world settings are examined. RESULTS: Patient and clinician behaviour as well as the incentives created by the health care system affect the likelihood of realising effective antidepressant therapy in practice. CONCLUSIONS: Given the complexities of clinical practice, selection criteria for an antidepressant should include safety, efficacy and tolerability, as well as the ability of the antidepressant to deliver real-world efficacy while balancing health care costs in the long term.
BACKGROUND: Current treatment for depression in primary care and other out-patient settings demonstrates a pattern that is incongruous with the magnitude of the burden of depression suggested by its associated disability. AIMS: To review important considerations in current depression treatment with a focus on antidepressant use. METHOD: Factors influencing the undertreatment of depression in real-world settings are examined. RESULTS:Patient and clinician behaviour as well as the incentives created by the health care system affect the likelihood of realising effective antidepressant therapy in practice. CONCLUSIONS: Given the complexities of clinical practice, selection criteria for an antidepressant should include safety, efficacy and tolerability, as well as the ability of the antidepressant to deliver real-world efficacy while balancing health care costs in the long term.
Authors: Mythily Subramaniam; Vincent Y F He; Janhavi A Vaingankar; Edimansyah Abdin; Siow Ann Chong Journal: BMC Psychiatry Date: 2013-09-23 Impact factor: 3.630