Pharmacopsychiatry 2014; 47(07): 259-262
DOI: 10.1055/s-0034-1387784
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Timing of Adjunctive Therapy in the Treatment of Depression: A Chart Review

R. Tarumi
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
,
T. Suzuki
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
2   Department of Psychiatry, Inokashira Hospital, Tokyo, Japan
,
H. Tani
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
3   Department of Psychiatry, Umesato Mental Clinic, Chiba, Japan
,
R. Den
4   Department of Psychiatry, Komagino Hospital, Tokyo, Japan
,
N. Sawada
5   Department of Psychiatry, Asakadai Mental Clinic, Saitama, Japan
6   Department of Ohizumi Hospital, Tokyo, Japan
,
H. Sakurai
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
2   Department of Psychiatry, Inokashira Hospital, Tokyo, Japan
,
C. Tsutsumi-Ozawa
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
4   Department of Psychiatry, Komagino Hospital, Tokyo, Japan
,
A. Ohtani
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
,
M. Mimura
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
,
H. Uchida
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
7   Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
8   Department of Psychiatry, Ohizumi Mental Clinic, Saitama, Japan
› Author Affiliations
Further Information

Publication History

received 01 July 2014
revised 05 August 2014

accepted 11 August 2014

Publication Date:
02 September 2014 (online)

Abstract

Introduction: The objective of this study was to examine the evolution of antidepressant switch and adjunctive therapy.

Methods: This chart review was conducted at 6 primary psychiatric clinics or hospitals, in Tokyo, Japan. A chart review of longitudinal prescriptions was conducted regarding 633 outpatients with major depressive disorder for up to 2 years after their first visit. Patients who had already received antidepressants prior to the visit were excluded.

Results: 22.6% (N=143) of the patients completed or continued the outpatient treatment over the 2 years while 27 (4.3%), 23 (3.6%), and 439 (69.4%) patients discontinued it due to hospitalization, referral to another clinic, and loss to follow-up, respectively. A total of 597 episodes of antidepressant treatment were identified. Among them, 482 episodes (80.7%) were associated with the suggested dose ranges while antidepressant drugs were under-dosed in 19.3% (N=115) of the episodes. 50 patients (7.9%) received adjunctive therapy; it was employed after a median of only one antidepressant had been tried.

Conclusion: Psychiatrists may be hasty in prescribing an adjunctive therapy in the treatment of depression.

 
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