Trends of drug prescription for depression treatment by primary care and community psychiatrists in Lithuania

Abstract

Aims To assess the medicines for depression prescribing patterns of primary care doctors and community psychiatrics during 2003. Methods Retrospective, longitudinal study of prescriptions on the basis of database of health insurance authority (Lithuanian Patient Funds). All reimbursed prescriptions for depression treatment written in 2003 year by community psychiatrists and general practitioners working for health service in Siauliai district with population of 363 000 citizens were collected. Drugs were classified according to the anatomic therapeutic chemical (ATC) System and use was quantified in terms of defined daily doses (DDDs). Data were expressed in DDD per 1000 inhabitants per day. As an indicator of the quality of drug prescribing, the DU90% was used. Results The total consumption of medicines for depression treatment in Siauliai was 4.3 DDD/1000 inhabitants/day. The most frequently prescribed drugs for depression treatment were as follows: sertraline (28.2%), lorazepam (19.9%), paroxetine (14.5%), citalopram (11.0%), fluvoxamine (6.4%), mirtazapine (5.3%), amitriptyline (4.5%), fluoxetine (2.6%) and accounted 90% of all prescriptions. The main classes of drugs used for depression treatment were: (i) antidepressants from the selective serotonin reuptake inhibitors (SSRIs) group that accounted 64.18% of all prescriptions, (ii) benzodiazepines – respectively 19.46%, (iii) other antidepressants (reboxetine, mirtazapine, venlafaxine) – 8.37%. Monoamine oxidase inhibitors (MAOIs) were not used at all. Conclusions Consumption of drugs for depression treatment in Lithuania is less than in other countries due to some restrictions for reimbursment. Among other factors influencing low drug usage may be low medical education of patients and their inefficiency to identify psychological problems or inability to seek for psychiatrist help (due to social and economical situation).