J Korean Neuropsychiatr Assoc.  2008 Jan;47(1):22-27.

Optimising Antidepressant Use in Clinical Practice: Considering External Factors

• Ham BJ
• Han CH

Abstract

Depressive illness is a major public health problem with important medical, social and economic implications. The efficacy of various antidepressants in treating depression has been demonstrated in randomized controlled trials (RCTs). However, these studies do not adequately address the complexities of clinical practice. Although most of RCTs assumed there was no difference in efficacy between the tricyclic antidepressants (TCAs) and serotonin specific reuptake inhibitors (SSRIs), naturalistic studies show that patients who take TCAs often receive subtherapeutic doses for inadequate duration than those with SSRIs. Because the benefits of the implementation of current guidelines are limited, the optimal choice of medication must be guided by detailed history and careful consideration of the real-world efficacy of antidepressants and long-term health care costs.

Keyword

Depression; Antidepressants; Optimal treatment

MeSH Terms

Antidepressive Agents
Antidepressive Agents, Tricyclic
Depression
Health Care Costs
Humans
Public Health
Serotonin
Antidepressive Agents
Antidepressive Agents, Tricyclic
Serotonin