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The authors are affiliated with the Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University (JHU), 624 N. Broadway HH850, Baltimore, MD 21205 (e-mail: firstname.lastname@example.org). Dr. Mojtabai is also with the Department of Psychiatry and Behavioral Sciences, JHU School of Medicine, Baltimore. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Copyright © American Psychiatric Association
Individuals prescribed antidepressants for depression often discontinue treatment prematurely or are only partially adherent (1), representing two major barriers to achieving successful outcomes. Most research on antidepressant treatment patterns has focused on major depression. To the best of our knowledge, patterns of use among individuals with other perceived treatment targets have not been investigated in community settings.
This study used data from the Eurobarometer 2010 survey to examine such patterns of antidepressant use (2). The survey was conducted in February and March 2010 and included 27,304 individuals age 15 years and older in the 27 European Union countries. Random sampling methods and weighting ensured demographically representative samples in each country. The survey ascertained any antidepressant use, reasons for use, and patterns of use.
Of the 1,960 participants who reported having used antidepressants in the past year and responded to relevant questions, 1,826 (93.7%) reported using antidepressants for depression, anxiety, chronic pain, or to enhance performance. Participants could choose more than one reason. Of the 1,826 participants, 893 (52.4%) reported using antidepressants regularly for at least four weeks, 185 (10.6%) regularly for less than four weeks, and 748 (37.1%) from time to time. The analyses found statistically significant differences in patterns of use by reason for use (design-based F=18.52, df=4 and 7,217, p<.001). As Figure 1 shows, individuals with more than one reason for use and those with depression were most likely to report regular use for four weeks or longer (65.7% and 63.3%, respectively); whereas only a minority of those citing performance enhancement reported regular use (18.0%). The percentages with anxiety and chronic pain reporting regular use for four weeks or longer fell in the middle—34.7% and 45.8%, respectively.
Occasional use of antidepressants is a common phenomenon; however, antidepressant trials have mainly assessed efficacy and effectiveness of these medications when they are used continuously. The effectiveness of occasional use, especially among individuals with anxiety disorders and chronic pain, should be investigated.
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