Reasons for antidepressant prescriptions in Canada

Purpose To describe reasons reported by physicians making recommendations for treatment with antidepressant medications. Methods Data collected by IMS Health Canada in a database called the Canadian Disease and Therapeutic Index (CDTI) were used in this analysis. CDTI data are collected from a representative sample of office-based physicians who complete diaries in their practices during selected sampling periods. A drug recommendation is recorded each time a treatment is recommended. The data are weighted to produce national estimates of the frequency of such recommendations. Results The frequency of recommendations for antidepressant treatment increased between 2000 and 2004. However, there was a slight decrease in 2005. Two types of antidepressant medications, tricyclic antidepressants (TCAs) and trazodone showed distinct patterns of use. TCAs were more commonly used for non-psychiatric indications than for psychiatric indications, especially for sleep- and pain-related reasons. Trazodone was frequently recommended for sleep problems. The proportion of recommendations for depressive disorders for antidepressants as a group remained stable over the 5-year study period. Conclusions About one-third of antidepressant recommendations are for reasons other than depression. It can no longer be assumed that the frequency of antidepressant use is a measure of the frequency of pharmacological depression treatment. However, prescription data may be useful for tracking trends. Copyright (c) 2007 John Wiley & Sons, Ltd.