Solving the problem of antidepressant selection

Abstract

Study Object

To ascertain the opinion of Lithuanian psychiatrists on depression treatment approach according to the type of depression.

Methods:

An original questionnaire of 30 questions, which deals with reliance of antidepressants selection according to the peculiarity of the depression psychopathology.

Results:

Respondents for organic depression chose mostly mirtazapin (47.4%), for depression with obsession – 35.3% chose paroxetine. It is intresting that despite the controversial opinion about the TCA prescribing according to their side effects profile and safety to use, our respondent chose amitriptylinum for the melancholic depression with suicidal thoughts (42.1%) and for the anaesthetic depression (28%). The study results showed that in some cases there is no unanimous opinion among the psychiatrists – data scattering was received in antidepressants selection, the respondents chose different antidepressants from different groups in similar frequency. For instance, for treatment of the adynamic depression - 7.5% - amitriptyline, 12% - citalopram, 10.5 % - reboxetin, 10.5 % - venlafaxin, 4.5 % - mirtazapine, for the anxious depression - 15% - amitriptyline, 18.8% - citalopram, 15% - mirtazapine, for the anaesthetic depression – 14% - escitaloprami, 9% - sertraline, 8.5% - venlafaxine. There is no clear tendency nor prevailing antidepressant.

Conclusions:

The clinical variety of depression is posing serious task for practitioners – to choose adequate therapy and right antidepressant. Data scattering shows that in some cases guidelines for antidepressant selection would significantly relieve the work of practitioners.