OBJECTIVES

: We investigate the prescribing pattern of antidepressants in relation to different diagnosis in king Salman armed forces hospital, North West region Saudi Arabia. The choice of medication as monotherapy, combination therapy and augmentation therapy is based on disease condition and physician choices.

METHODS

: A retrospective case notes review was done between August 2015 to October 2015.out of 1220 prescription, 480 prescriptions fulfilled the criteria of inclusion. Data analysis was done using the SPSS version 23.

RESULTS

: Depression without psychotic features comprising 55% of the sample, was the most frequent diagnosis followed by anxiety disorder (24%), social anxiety (4%), mixed anxiety(1.7%), depression with psychotic features (5%), panic attacks (4.8%),obsessive compulsive disorder (3.5%), adjustment disorder (2.1%). All patients were prescribed with antidepressants , the most common was SSRIS (37.5%), followed by noradrenaline and specific serotonin antidepressant (9.8%), selective norepinephrine reuptake inhibitor SNRI (8.1%), tricyclic antidepressant TCA (3.8%) and finally melatonergic agonist (0.2%0) Monotherapy was prescribed for more than half of the patient (59.4%) while 32.9 % of the patients received combination therapy with SSRI-NaSSA , the most preferred combination and 7.7% required augmentation of antidepressants with antipsychotics. Escitalopram is the most commonly prescribed drug 20.2% followed by paroxetine 9.8% and mirtazapine 9.8%. Monotherapy (p=0.000) , combination therapy (p=0.000) and augmentation (p=0.62) treatments are used most often for depression and then for anxiety.

CONCLUSIONS

: Antidepressants are prescribed mainly for depression followed by anxiety disorder either as single agent treatment or combination or as augmentation therapy. The choice of treatment based on patient specific condition and physician preference. SSRI,s are the most commonly prescribed group of antidepressant and escitalopram is the most commonly prescribed drug followed by mirtazapine. The treatment options were cost effectiveness. Most preferred combination is of SSRI-NaSSA. These information could help overseeing treatment adherence and outcome.