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Size does matter: A study of antidepressant prescribing in a general hospital

  • Alan J. Carson (a1) and Prem Shah (a1)
Abstract
Aims and Methods

To examine antidepressant prescribing in a general medical hospital in the UK. The data used were extracted from a prescription database prospectively maintained by the hospital pharmacy. All prescriptions of antidepressants over a five-year period, both new and continuation, were recorded.

Results

During the study period there were 2037 prescriptions of tricyclic antidepressants. Only 18% of these prescriptions were at conventional therapeutic doses. This compared with 773 prescriptions of selective serotonin reuptake inhibitors, 70% of which were at conventional therapeutic doses. It is shown that antidepressants were prescribed at a dose in accordance with the smallest tablet size available.

Clinical Implications

We suggest that reformulation of tablets to allow one tablet daily prescribing may lead to improved antidepressant prescribing.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Anderson, I. M. & Tomenson, B. M. (1995) Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis. British Medical Journal, 310, 14331438.
Donoghue, J., Tylee, A. & Wildgust, H. (1996) Cross-sectional database analysis of antidepressant prescribing in general practice in the United Kingdom, 1993–1995. British Medical Journal, 313, 861862.
Macdonald, T. M., Macmahon, A. D., Red, I.C., et al (1996) Antidepressant drug use in primary care: a record linkage study in Tayside, Scotland. British Medical Journal, 313, 860861.
Perry, P. J. (1996) Pharmacotherapy for major depression with melancholic features: relative efficacy of tricyclics versus selective serotonin reuptake inhibitor antidepressants. Journal of Affective Disorders, 39, 16.
Tan, R. S. (1997) Prescribing antidepressants in general practice. Low dose tricyclic antidepressants are effective in treating major depression. British Medical Journal, 314, 827.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Size does matter: A study of antidepressant prescribing in a general hospital

  • Alan J. Carson (a1) and Prem Shah (a1)
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