Treatment of major depression in psychiatric outpatient care: Position of new antidepressants

Abstract

Treatment of major depression in standard clinical practice has been an underexamined topic. We studied the management of major depression in psychiatric outpatient care with special reference to the position of the new antidepressants. We sent questionnaires concerning treatment practice of major depression to 255 physicians (of whom 216 returned questionnaires) in communal psychiatric outpatient care covering all Finland. In general, clinical features of the illness, not the physicians' characteristics, seemed to determine which antidepressants they chose. Nearly 75% of the physicians chose the new antidepressants —mainly the selective serotonin reuptake inhibitors — as the first-line drugs. This breakthrough seemed to be connected with their low side-effect profile. Drug compliance of antidepressants is the crucial point in the pharmacotreatment of major depression in standard clinical practice. These data also raise some concern about the possible overuse of the new antidepressants in psychiatric outpatient care.

Key Words:

• Antidepressants
• Compliance
• Major depression
• Outpatient care
• Treatment practice