Antidepressant dose patterns in Swedish clinical practice

The Swedish Diagnosis and Therapy Survey was used to analyse the prescribing of antidepressants from 1991 to 1996. There were considerable differences in doses prescribed depending on diagnosis. Adequate dosage is an important factor in antidepressant treatment, and this study showed that tricyclic antidepressants are often prescribed at lower than recommended doses for the treatment of depression. Significantly higher doses were prescribed in continued treatment, as opposed to in new treatment, indicating dose titration when using tricyclic antidepressants and the most common selective serotonin reuptake inhibitors in depression. The findings from the present study suggest that the optimal dosage for some of the new antidepressants in clinical practice has not yet been determined and that costs of treatment in a natural setting might be considerably higher than costs calculated from dose recommendations.