Managing antidepressants in primary care: physicians' treatment modifications |
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Authors: | Tamburrino Marijo B Nagel Rollin W Lynch Denis J |
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Affiliation: | Department of Psychiatry, University of Toledo, 3000 Arlington Avenue, Mail Stop 1193, Toledo, OH 43614-2598, USA. marijo.tamburrino@utoledo.edu |
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Abstract: | To examine antidepressant management practices in primary care, patients (N = 148) given an antidepressant for at least one month completed the Beck Depression Inventory (BDI-II), the Patient Health Questionnaire-9 (PHQ-9), and a demographic survey. Participants' mean age was 50.7 yr. and 80% were women. Patients' charts indicated whether physicians had made changes to prescribed antidepressants or dose either 6 wk. before or 6 wk. after study entry. For the 87% of participants whose depression status could be determined, 10% met dysthymic disorder criteria and only 33% had had a medication change in the previous month. Major depressive disorder occurred in 37% but only 18% had had a medication change. Co-existing dysthymic disorder and major depressive disorder were diagnosed in 34%, with 24% receiving a medication change. Participants not receiving a medication change had mean BDI-II scores indicating moderate depression. Lack of antidepressant adjustment suggests physicians may need to monitor depressive symptoms closely using protocols and prompts. |
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