North of England evidence-based guideline development project: summary version of guidelines for the choice of antidepressants for depression in primary care

Advances in psychiatric treatment in primary care

“…They reported similar total health care costs, with higher fluoxetine drug costs balanced by fewer out-patient and inpatient contacts with medical and mental health services. The North of England Evidence-Based Guideline Development Project (Eccles et al, 1999) undertook a detailed cost-benefit analysis of the direct health care costs of the major antidepressant groups, including drug costs, toxicity admissions and notional lives saved. Their meta-analysis of existing studies concluded that tricyclic antidepressants should be used as routine first-line treatment for depression in primary care, with lofepramine as a more cost-effective option than an SSRI if toxic effects of the first-generation tricyclics are perceived to be a problem.…”

The clinical management of a patient with depressive disorder: a case vignette study to examine general practitioners' views

“…The two-thirds who would not are in accord with expert guidelines on appropriate management. Evidencebased guidelines recommend TCAs should be the treatment of first choice in the primary care of depression (Eccles et al, 1999), although in this sample SSRIs were most favoured among GPs and there is independent evidence of a rising popularity in the use of SSRIs (Martin et al, 1997). This might reflect the impact of aggressive marketing of SSRIs since the guidelines were introduced, as well as a significant body of opinion that SSRIs are preferable as a first-line treatment.…”

A ‘Situational Approach’ To Mental Health Literacy In Australia

“…12,13 In Australia, antidepressant utilisation nearly trebled between 1990 and 1998, and has continued to increase. 14,15,16 It is interesting to note that, of OECD nations, Australia is currently the second-highest prescriber of antidepressant drugs.…”