OPEN IN READ APP
JOURNAL ARTICLE

The use of antidepressants and therapeutic drug monitoring by general practitioners and psychiatrists: findings from a questionnaire survey in two Swedish areas

G Isacsson, U Bergman, D Wasserman, I Redfors, F Sjöqvist
Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists 1996, 8 (3): 153-60
8899133
We wished to assess general practitioners' and psychiatrists' sensitivity and specificity in the diagnosis of depression, rationale for drug of choice, average and range of prescribed daily doses of antidepressants, and use of therapeutic drug monitoring (TDM). A questionnaire survey was given to 264 psychiatrists and general practitioners (GPs) in one urban area of Stockholm and the rural county of Jamtland, Sweden. The response rate was 86% (n = 228). The survey was validated against independent studies of actual prescription rates. One of eight physicians presented with a hypothetical case history of major depression appeared unwilling to use antidepressants. Two-thirds of the GPs and one-fourth of the psychiatrists usually prescribed doses that were too low. Many doctors never prescribed doses higher than 150 mg/day of common tricyclic antidepressants, although many patients clearly need higher doses. The choice of drug was based mostly on the therapeutic tradition and seldom on considerations of scientific evidence. The few physicians who utilized TDM (plasma concentrations) for dosing prescribed a more flexible dosage schedule and higher average doses as well as higher maximal doses. Interestingly, there were no significant differences in dosing between GPs and psychiatrists in this group, while striking differences were found in the whole study group, with GPs prescribing much smaller doses. Regular use of TDM as a means for individualizing the dose regimen of antidepressants should be encouraged, as well as continuous education of general practitioners in the diagnosis and treatment of depression.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
8899133
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"