Medication for depression ended before recommended time

Dec 10 2010

Swedish women's use of antidepressants is twice as high as that of Swedish men. However, among both female and male new users, one fifth fills only one prescription. 
"This can be an indication of choices being made to end treatment before the recommended time," says researcher Karolina Andersson Sundell at the Nordic School of Public Health.

Depression is expected to constitute the second largest source of global burden of disease after heart disease by the year 2020. The consequences for society and individuals are lowered quality of life, social isolation, decreased intellectual capacity as well as an inability to carry out activities of daily living. Additional consequences are significantly affected health levels, an increased need for institutionalized care along with an increased risk of suicide.

A register study of young adults who purchased at least one antidepressant in 2006 has been carried out by Karolina Andersson Sundell, Mika Gissler and Max Petzold of the Nordic School of Public Health and Margda Waern of the University of Gothenburg.

The study shows that between 4 to 13 percent of Swedes aged 20-34 use antidepressants. Almost twice as many users are women. Furthermore, 2.5 percent also use another mood stabilizer.  Among those who use antidepressants, every tenth also purchases antipsychotics. Many furthermore only purchased their antidepressant medication once, indicating that the drug was not used optimally - the minimum duration of treatment recommended is six months after the depression has passed.  

Patients make this choice independently

"What we need to do now is to monitor this for a longer period of time to see if they return and purchase antidepressants again, at a later stage. We currently lack knowledge regarding the reasons for why only one purchase is made, meaning additional studies are required. Previous international research however indicates that patients often make this choice independently and seldom inform their prescription provider why they decided to stop taking the medication," says Andersson Sundell.

The results indicate an elevated mortality rate among both men and women using antidepressants in combination with mood stabilizers. The use of lithium did however not follow this pattern.

Increased mortality was seen

"One possible reason is that lithium users receive better follow-ups," says Andersson Sundell. Increased mortality was also seen among the group of individuals who filled prescriptions for both antidepressants and antipsychotics.
"Further studies are needed to map the reasons for the elevated mortality rates," says researcher Karolina Andersson Sundell at the Nordic School of Public Health.

The causal connection between medication use and a higher rate of illness, as well as that between the use of multiple types of medication and even higher rates of illness are factors to consider in this context, but the researchers nevertheless see significant tendencies in the study.

http://www.nhv.se/depressionmedication