Charles Ouazana Vedrines, Nicolas Hoertel, Thomas Lesuffleur, Pierre Denis, Mark Olfson, Carlos Blanco, Frédéric Limosin, Antoine Rachas, Philippe Tuppin, Cédric Lemogne
{"title":"Sex Differences in Antidepressant Acceptability According to Filled Prescription Sequences in a Nationwide Cohort Study.","authors":"Charles Ouazana Vedrines, Nicolas Hoertel, Thomas Lesuffleur, Pierre Denis, Mark Olfson, Carlos Blanco, Frédéric Limosin, Antoine Rachas, Philippe Tuppin, Cédric Lemogne","doi":"10.4088/JCP.23m15128","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> The prevalence of depressive and anxiety disorders is higher in women than in men. In contrast, there is still no clear consensus on the existence of sex-related differences in the effectiveness of antidepressant treatments for these disorders. This real-world study used filled prescription sequences to compare antidepressant medications between women and men at a medication level according to their acceptability (ie, combination of efficacy and tolerability).</p><p><p><b>Methods:</b> In a nationwide cohort from the French national health data system (Système National des Données de Santé [SNDS]), 1.2 million people were identified as new antidepressant users for any condition in 2011. The outcome was clinical acceptability as measured by the continuation/change ratio over the 6- month period following the introduction of the first-line treatment. Continuation was defined as at least 2 refills of the same treatment. Change was defined as at least one filled prescription of another antidepressant, an antipsychotic medication, or a mood stabilizer. Adjusted odds ratios (aORs) were computed through multivariable binary logistic regressions.</p><p><p><b>Results:</b> Overall, after the first prescription of an antidepressant, the continuation/ change ratio was slightly higher for women than men (aOR [95% CI], 1.06 [1.05-1.08]), with escitalopram ranking first in both. Sex-by-medication interactions were significant for paroxetine (0.91 [0.88-0.95]) and fluoxetine (1.19 [1.12-1.26]) only. Specifically, fluoxetine was significantly more acceptable in female than in male participants (0.73 [0.70-0.75] vs 0.63 [0.60-0.67]), whereas paroxetine was more acceptable in male than in female participants (0.75 [0.72-0.78] vs 0.68 [0.66-0.70]).</p><p><p><b>Conclusion:</b> These real-world data may help practitioners and policymakers prioritize choice of antidepressant medications in women and men.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"85 4","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4088/JCP.23m15128","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The prevalence of depressive and anxiety disorders is higher in women than in men. In contrast, there is still no clear consensus on the existence of sex-related differences in the effectiveness of antidepressant treatments for these disorders. This real-world study used filled prescription sequences to compare antidepressant medications between women and men at a medication level according to their acceptability (ie, combination of efficacy and tolerability).
Methods: In a nationwide cohort from the French national health data system (Système National des Données de Santé [SNDS]), 1.2 million people were identified as new antidepressant users for any condition in 2011. The outcome was clinical acceptability as measured by the continuation/change ratio over the 6- month period following the introduction of the first-line treatment. Continuation was defined as at least 2 refills of the same treatment. Change was defined as at least one filled prescription of another antidepressant, an antipsychotic medication, or a mood stabilizer. Adjusted odds ratios (aORs) were computed through multivariable binary logistic regressions.
Results: Overall, after the first prescription of an antidepressant, the continuation/ change ratio was slightly higher for women than men (aOR [95% CI], 1.06 [1.05-1.08]), with escitalopram ranking first in both. Sex-by-medication interactions were significant for paroxetine (0.91 [0.88-0.95]) and fluoxetine (1.19 [1.12-1.26]) only. Specifically, fluoxetine was significantly more acceptable in female than in male participants (0.73 [0.70-0.75] vs 0.63 [0.60-0.67]), whereas paroxetine was more acceptable in male than in female participants (0.75 [0.72-0.78] vs 0.68 [0.66-0.70]).
Conclusion: These real-world data may help practitioners and policymakers prioritize choice of antidepressant medications in women and men.
期刊介绍:
For over 75 years, The Journal of Clinical Psychiatry has been a leading source of peer-reviewed articles offering the latest information on mental health topics to psychiatrists and other medical professionals.The Journal of Clinical Psychiatry is the leading psychiatric resource for clinical information and covers disorders including depression, bipolar disorder, schizophrenia, anxiety, addiction, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder while exploring the newest advances in diagnosis and treatment.