Antidepressant treatment before hospitalization for major depression: Often prescribed, often undertitrated

Fifty-three patients hospitalised for major depression were given a semi-structured interview to collect data allowing to consider the question of treatment in the period preceding hospitalisation. Twenty-one patients were discarded because they did not consult any physician (n=5) or because they did it too late (n=11) or for they reached the threshold of major depression too late to allow sufficient time for efficacy of the treatment (n=5). There remained a subsample of 20 potentially treatable patients. The majority of them refused their treatment (17%), were given no antidepressant treatment (14%) or at an insufficient dose (41%). If they received a sufficient dose, it was too lately (3%) or it was a maintenance therapy, which had not been modified in spite of a recurrence (14%), and finally only 10% of the potentially treatable patients could be considered as adequately treated, from a psychopharmacological point of view. (C) 1997 The Italian Pharmacological Society.