Prescription patterns of psychotropic medication for treatment of affective disorders

Major Depressive Disorder (MDD) is a highly prevalent and serious illness with a high burden for both the individual and the society. In the Netherlands, a depression yearly takes 168.000 Disability Adjusted Life Years (RIVM, 2013) and generates almost 3 billion euros of direct and indirect costs (De Graaf et al., 2011; Slobbe et al., 2011). Pharmacological treatment using antidepressants is effective, but suboptimal with low response- and remission rates (Rush et al., 2006; Souery et al., 2007). High variance in treatment practice, perhaps due to limited guideline adherence, may interfere with optimal treatment (Kessler et al., 2003, Schneider et al., 2005; Trivedi et al., 2007) and studies have shown that stricter guideline adherence results in better symptom reduction and less relapses (Melfi et al., 1998; Hepner et al., 2007).

The prevalence of inappropriate variance and limited guideline adherence in treatment of depression in the (Northern) Netherlands has not yet been thoroughly investigated. The goal of the current study is to describe the recent treatment practices of depression in the Northern Netherlands and quantify signs of inappropriate variance and guideline adherence. Knowledge on the current status can act as a starting point for future developments to improve the prognosis of depression.