J Korean Neurol Assoc.  2019 May;37(2):156-160. 10.17340/jkna.2019.2.6.

Prescription Pattern of Antidepressants in Korea for Major Neurological Disorders: Before the Policy Change in 2017

• Park Y
• Baek ES
• Choi J
• Lee J
• Lee SH
• Park KW

• KMID: 2454841
• DOI: http://doi.org/10.17340/jkna.2019.2.6

Abstract

BACKGROUND
It is well known that patients with neurological disorders are vulnerable to depression. However, in Korea, National Health Insurance services had banned non-psychiatrists from prescribing antidepressants for more than 2 months until January 2017. Now, neurologists are able to prescribe antidepressants to patients with only four neurological disorders. Due to this recent change in national health insurance policy, there will be a large change in the prescription pattern of antidepressants. In this study, we performed an analysis of antidepressant prescription patterns in Korea prior to this recent policy change.
METHODS
The source population of this retrospective cohort study is the Health Insurance Review & Assessment Service database. We analyzed the claim database for patients who have one of four major neurologic disorders and had healthcare documentation submitted by healthcare providers between January 1, 2011 and December 31, 2016.
RESULTS
During 2012-2016, antidepressant prescription rates of 6.21% (127,192 of a total 2,048,165 patients), 9.93% (81,861 out of 824,290), 10.12% (173,582 of 1,714,776), and 13.36% (48,530 of 363,347) were found for cerebrovascular disease, epilepsy, dementia, and Parkinson's disease respectively. The most frequently prescribed antidepressant in cerebrovascular disease and epilepsy was tricyclic antidepressants (TCAs). In Parkinson's disease and dementia, the most frequently used antidepressant was selective serotonin reuptake inhibitors.
CONCLUSIONS
The overall prescription rate of antidepressants was much lower than the estimated rates reported in other countries. TCAs were the primarily prescribed antidepressant. It is now expected that TCAs will be replaced by newer antidepressants.

Keyword

Depression; Antidepressive agents; Nervous system diseases

MeSH Terms

Antidepressive Agents*
Antidepressive Agents, Tricyclic
Cerebrovascular Disorders
Cohort Studies
Delivery of Health Care
Dementia
Depression
Epilepsy
Health Personnel
Humans
Insurance, Health
Korea*
National Health Programs
Nervous System Diseases*
Parkinson Disease
Prescriptions*
Retrospective Studies
Serotonin Uptake Inhibitors
Antidepressive Agents
Antidepressive Agents, Tricyclic
Serotonin Uptake Inhibitors