Pharmacotherapeutic strategies for patients treated for depression in UK primary care: a database analysis

Lamy, François-Xavier; Chollet, Julien; Clay, E.; Brignone, M.; Rive, B.; Saragoussi, Delphine

doi:10.1185/03007995.2015.1020362

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…In addition, this is one of the first studies in which the collected baseline data comprise such a wealth of naturalistic information, including detailed individual medical histories and both physician- and patient-reported information on the current depressive episode, as well as functional, quality-of-life and resource-use data. The study population had the expected demographic characteristics of patients with depression: as previously reported in other observational studies, the majority of patients with depression were women, and the mean age of the population was approximately 45 years [ 11 , 51 , 52 ]. Although the categorization of depression severity using patient-reported outcome in the majority of patients in the present study (rather than by scales more frequently used in clinical trials) may be perceived as a limitation of the study, this approach is increasingly recognised as appropriate and may be considered a study strength.…”

Section: Discussionmentioning

confidence: 89%

Characteristics of patients with depression initiating or switching antidepressant treatment: baseline analyses of the PERFORM cohort study

et al. 2018

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BackgroundPatients who require a switch in their antidepressant therapy may have different clinical profiles and treatment needs compared with patients initiating or maintaining a first-line antidepressant therapy.MethodsThe Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (MDD) (PERFORM) study was a 2-year observational cohort study in outpatients with MDD in five European countries. Enrolled patients were either initiating or undergoing the first switch to an antidepressant monotherapy. Baseline data on patients’ clinical status, functioning, productivity, quality of life and medical-resource use were compared in a cross-sectional baseline analysis.ResultsA total of 1402 patients were enrolled, of whom 1159 (82.7%) provided analysable baseline data. The majority (78.7%) of the analysable population were initiating antidepressant treatment and most (83.6%) were enrolled and followed up by general practitioners. Compared with patients initiating antidepressants, those switching antidepressants (21.3%) tended to have more severe depressive symptoms, greater anxiety, worse health-related quality of life, greater functional impairment, greater medical-resource use and had a different medical history. Limitations included an over-representation of switches due to lack of efficacy among patients who were switching treatment, as patients were selected based on presence of depressive symptoms.ConclusionsPatients with MDD who are switching treatment for the first time have a different profile and different depression-associated health needs compared with those initiating treatment. Therapeutic management should therefore be adapted for patients who switch.Trial registrationClinicalTrials.gov NCT01427439; Retrospectively registered 26 August 2011.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1657-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 89%

Characteristics of patients with depression initiating or switching antidepressant treatment: baseline analyses of the PERFORM cohort study

et al. 2018

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Comparative evaluation of vortioxetine as a switch therapy in patients with major depressive disorder

Thase

Danchenko²,

Brignone³

et al. 2017

European Neuropsychopharmacology

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Switching antidepressant therapy is a recommended strategy for depressed patients who neither respond to nor tolerate an initial pharmacotherapy course. This paper reviews the efficacy and tolerability of switching to vortioxetine. All three published studies of patients with major depressive disorder (MDD) switched from SSRI/SNRI therapy to vortioxetine due to lack of efficacy or tolerability were selected. Vortioxetine was evaluated versus agomelatine directly (REVIVE) and versus sertraline, venlafaxine, bupropion, and citalopram in an indirect treatment comparison (ITC) from switch studies retrieved in a literature review. Vortioxetine׳s impact on SSRI-induced treatment-emergent sexual dysfunction (TESD) was assessed directly versus escitalopram (NCT01364649) in stable patients with MDD. Vortioxetine׳s tolerability in the switch population was compared to the overall MDD population. Vortioxetine showed significant benefits over agomelatine on efficacy, functioning, and quality-of-life outcomes, with fewer withdrawals due to adverse events (AEs) (REVIVE). Vortioxetine had numerically higher remission rates versus all therapies included (ITC). Withdrawal rates due to AEs were significantly lower for vortioxetine versus sertraline, venlafaxine, and bupropion, and numerically lower versus citalopram. Switching to vortioxetine was statistically superior to escitalopram in improving TESD (NCT01364649). Tolerability was similar in the switch and overall MDD populations. These findings suggest that vortioxetine is an effective switch therapy for patients with MDD whose response to SSRI/SNRI therapy is inadequate. Vortioxetine was well tolerated and, for patients with a history of TESD, showed significant advantages versus escitalopram. Vortioxetine appears to be a valid option for patients with MDD who have not been effectively treated with first-line pharmacotherapies.

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The use of adjunctive antipsychotics to treat depression in UK primary care

Lamy¹,

Saragoussi²,

Johnson

et al. 2017

Current Medical Research and Opinion

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Antipsychotics were rarely used to treat depression between 2005-2013 in UK primary care. The choice of adjunctive antipsychotic therapy changed over this time, with atypical antipsychotics now representing the preferred treatment choice. However, information on patients strictly cared for in other settings, such as by psychiatrists or in hospitals, potentially more severe patients, was unavailable and may differ. Nonetheless, the high off-label use in primary care, even after the authorization of quetiapine, suggests that there is a need for more licensed treatment options for adjunctive antipsychotic therapy in major depressive disorder.

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Pharmacotherapeutic strategies for patients treated for depression in UK primary care: a database analysis

Cited by 3 publications

References 42 publications

Characteristics of patients with depression initiating or switching antidepressant treatment: baseline analyses of the PERFORM cohort study

Characteristics of patients with depression initiating or switching antidepressant treatment: baseline analyses of the PERFORM cohort study

Comparative evaluation of vortioxetine as a switch therapy in patients with major depressive disorder

The use of adjunctive antipsychotics to treat depression in UK primary care

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