Prospective Observation of Switching Rate of Antidepressants in Management of Depressive Episode in 3 Months

Abstract

Objective: to observe prospectively of switching rate of antidepressants in management of depressive episode. Methods: 190 patients with depressive episode treated by antidepressants were observed for 3 months and switching rate were assessed under “best natural therapy”. And switching criteria was following: 1) manic or hypomanic episode; or 2) promoting rapid cycling; or 3) YMRS ≥ 11 or irritability or aggravation in YMRS ≥ 3. 4) Psychiatrist thinks that the patients should be stopped to take antidepressants and should be placed by mood stabilizer or antipsychotics or their combination. Results: 1) 18 of 190 patients was found to switch in 3 month therapy. The switching rate was 9.47%. 2) 4 of 61 males was found and 14 females was found to switch, their switching rate was not significant (6.56%, 10.85%, X 2 = 0.89, P > 0.05). 3) 10 of 170 unipolar depression and 8 of bipolar depression was found to switch, their switching rate was very significant (5.88%, 40%, X 2 = 24.29, P < 0.01). 4) 5 of 36 patients token mood stabilizer and 13 patients not token mood stabilizer was found to switch, their switching rate was not significant (13.8%, 8.44%, X 2 = 1.47, P > 0.05). 5) 7 of 54 patients token more two antidepressants and 11 patients token single antidepressant was found to switch, their switching rate was not significant (12.96%, 8.08%, X 2 = 1.07, P > 0.05). 6) 7 of 38 patients with family history of mood disorder and 11 of patients without family history of mood disorder was found to switch, their switching rate was significant (18.4%, 7.23%, X 2 = 4.43, P < 0.05). 7) The switching often carried out at one month after treatment with antidepressants. 8) The significant difference in switching rate among various antidepressants were not found. Conclusion: Some depressive patients may switch during treatment with antidepressant, it should be stressed on.