The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries.

Abstract

INTRODUCTION:

Due to favorable antidepressant (AD) efficacy and tolerability, selective-serotonin reuptake inhibitors (SSRIs) are consistently recommended as substances of first choice for the treatment of major depressive disorder (MDD) in international guidelines. However, little is known about the real-world clinical correlates of patients primarily prescribed SSRIs in contrast to those receiving alternative first-line ADs.

METHODS:

These secondary analyses are based on a naturalistic, multinational cross-sectional study conducted by the European Group for the Study of Resistant Depression at ten research sites. We compared the socio-demographic and clinical characteristics of 1410 patients with primary MDD, who were either prescribed SSRIs or alternative substances as first-line AD treatment, using chi-squared tests, analyses of covariance, and logistic regression analyses.

RESULTS:

SSRIs were prescribed in 52.1% of MDD patients who showed lower odds for unemployment, current severity of depressive symptoms, melancholic features, suicidality, as well as current inpatient treatment compared to patients receiving alternative first-line ADs. Furthermore, patients prescribed SSRIs less likely received add-on therapies including AD combination and augmentation with antipsychotics, and exhibited a trend towards higher response rates.

CONCLUSION:

A more favorable socio-demographic and clinical profile associated with SSRIs in contrast to alternative first-line ADs may have guided European psychiatrists' treatment choice for SSRIs, rather than any relevant pharmacological differences in mechanisms of action of the investigated ADs. Our results must be cautiously interpreted in light of predictable biases resulting from the open treatment selection, the possible allocation of less severely ill patients to SSRIs as well as the cross-sectional study design that does not allow to ascertain any causal conclusions.

• Authors: Gernot Fugger, Lucie Bartova, Chiara Fabbri, Giuseppe Fanelli, Markus Dold, Marleen Margret Mignon Swoboda, Alexander Kautzky, Joseph Zohar, Daniel Souery, Julien Mendlewicz, Stuart Montgomery, Dan Rujescu, Alessandro Serretti, Siegfried Kasper
• Journal: European archives of psychiatry and clinical neuroscience (Eur Arch Psychiatry Clin Neurosci) Vol. 272 Issue 4 Pg. 715-727 (Jun 2022) ISSN: 1433-8491 [Electronic] Germany
• PMID: 34989830 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Chemical References

• Antidepressive Agents
• Antipsychotic Agents
• Serotonin Uptake Inhibitors

Topics

• Antidepressive Agents (pharmacology, therapeutic use)
• Antipsychotic Agents (therapeutic use)
• Cross-Sectional Studies
• Depressive Disorder, Major (drug therapy)
• Humans
• Selective Serotonin Reuptake Inhibitors (therapeutic use)