Prescribing patterns of antidepressants in Europe: results from the factors influencing depression endpoints research (FINDER) study
Open accessAbstract
Antidepressant prescribing patterns and factors influencing the choice of antidepressant for the treatment of depression were examined in the Factors Influencing Depression Endpoints Research (FINDER) study, a prospective, observational study in 12 European countries of 3468 adults about to start antidepressant medication for their first episode of depression or a new episode of recurrent depression. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly prescribed antidepressant (63.3% patients), followed by serotonin-norepinephrine reuptake inhibitors (SNRIs, 13.6%), but there was considerable variation across countries. Notably, tricyclic and tetracyclic antidepressants (TCAs) were prescribed for 26.5% patients in Germany. The choice of the antidepressant prescribed was strongly influenced by the previous use of antidepressants, which was significantly associated with the prescription of a SSRI (OR 0.64; 95% CI 0.54, 0.76), a SNRI (OR 1.49; 95% CI 1.18, 1.88) or a combination of antidepressants (OR 2.78; 95% CI 1.96, 3.96). Physician factors (age, gender, speciality) and patient factors (severity of depression, age, education, smoking, number of current physical conditions and functional syndromes) were associated with initial antidepressant choice in some models. In conclusion, the prescribing of antidepressants varies by country, and the type of antidepressant chosen is influenced by physician- as well as patient-related factors.
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Some studies revealed that low dose prescriptions were especially related to primary care physicians.
“Some studies further revealed that low dose prescriptions were especially related to primary care physicians, perhaps due to their concerns about the side effects related to TCAs, or the lack of confidence of those general practitioners (34, 38, 40).”
A few studies suggested that older antidepressants such as TCAs were more susceptible to be prescribed in low doses.
“A few studies suggested that older antidepressants such as TCAs were more susceptible to be prescribed in low doses (34, 38, 39), which was consistent with our study.”
In most countries in Europe, SSRIs were the class prescribed most frequently in 2004-2005, especially in France and the UK, whereas in Germany TCAs dominated.
“In most countries in Europe, SSRIs were the class being prescribed most frequently in 2004–2005, especially in France and the UK, whereas in Germany TCAs dominated (34).”
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References 39 · Cited by 186
Research works printed but not linked: 2
- Garcia-Cebrian A, Bauer M, Montejo AL, Dantchev N, Demyttenaere K, Gandhi P, et al. Characteristics of depressed outpatients entering the Fac- tors Influencing Depression Endpoints Research (FINDER) study. Eur Psychiatry 2008;23:57e65.
- Williams JW, Mulrow CD, Chiquette E, Hitchcock P, Aguilar C, Cornell J. A systematic review of newer pharmacotherapies for depression in adults: evidence report summary. Ann Intern Med 2000;132:743e56.
- Authors
- Bauer, M., Monz, B. U., Montejo, A. L., Quail, D., Dantchev, N., Demyttenaere, K., Garcia-Cebrian, A., Grassi, L., Perahia, D. G. S., Reed, C., & Tylee, A.
- Affiliations
- University Hospital Carl Gustav Carus (DE)
- Boehringer Ingelheim (Germany) (DE)
- Complejo Hospitalario de Salamanca (ES)
- Eli Lilly (United Kingdom) (GB)
- Hôtel-Dieu de Paris (FR)
- Universitair Ziekenhuis Leuven (BE)
- University of Ferrara (IT)
- Corresponding author
- Bauer, Michael
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2008-01
- Volume
- 23
- Issue
- 1
- Pages
- 66-73
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2011165558
- Cited by
- 186
- References
- 39
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 11 · 2022: 7 · 2021: 13 · 2020: 10 · 2019: 10 · 2018: 10 · 2017: 15 · 2016: 13 · 2015: 14 · 2014: 18 · 2013: 13 · 2012: 15
- FWCI
- 6.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- antidepressant prescribing, antidepressant selection, depression, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, tetracyclic antidepressants, recurrent depression, first-episode depression, physician characteristics, patient factors, cross-national variation
- MeSH terms
- Antidepressive Agents, Antidepressive Agents, Tricyclic, Cross-Cultural Comparison, Depressive Disorder, Drug Therapy, Combination, Europe, Germany, Humans, Practice Patterns, Physicians', Drug Prescriptions, Primary Health Care, Research Design, Retrospective Studies, Selective Serotonin Reuptake Inhibitors, Adrenergic Uptake Inhibitors, Secondary Prevention
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