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      Consumo de antidepresivos en Chile entre 1992 y 2004 Translated title: Consumption of antidepressants in Chile from 1992 to 2004

      research-article
      , ,
      Revista médica de Chile
      Sociedad Médica de Santiago
      Antidepressive agents, Fluoxetine, Mood disorders

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          Translated abstract

          Background: Data from the Ministry ofHealth show that in Chile in 2004, 17% of the population had some form of depression and mood disorders are the tenth cause of disability-adjusted Ufe years (DALY) loss. Aim: To determine consumption of antidepressants (ADs) in Chile from 1992 to 2004. Material and methods: National sales data were obtained from the company IMS Health Chile and converted into defined daily doses (DDDs) per 1,000 inhabitants per day Available ADs were classified in four pharmacological groups (Le., serotonin-norepinephrine reuptake inhibitors, SNRLs; selective-serotonin reuptake inhibitors, SSRLs; tñcyclic antidepressants, TCAs; and others). Total economic burden of ADs utilization and cost per DDDs were also calculated. Trends over time were analyzed using Pearson-R2. Results: Total ADs consumption in Chile measured by DDDs per 1,000 inhabitants per day (DHD) increased linearly (y =0.901x+1.9129; R2 =0.9296; p <0.001) from 2.5 in 1992 to 11.7 in 2004 (total growth of 470.2%). SSRLs were the drug class with higher consumption, and ñuoxetine the most commonly consumed antidepressant. SSRLs were the drugs that dominated the market representing 79% of the total drug consumption throughout the years. Total economic burden of ADs in Chile (total cost ofDDDs consumed) increased from US$65.4 million in 2001 to US$74.6 million in 2004 (14% increase). Average cost per DDD of all AD increased linearly, however not significantly from US\(0.94 in 2001 to US\) 1.04 in 2004 (y =0.0362x+0.8784; R2 =0.7382; p =0,262). Conclusions: DDDs per 1,000 inhabitants per day increased linearly over 470% from 1992-2004. SSRLs were the most commonly consumed drugs in Chile. Future research should evalúate the cost-effectiveness of antidepressants in Chile, comparing the results with drug utilization, and determining if unnecessary expenditures have been paid out.

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          Most cited references23

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          Does incomplete recovery from first lifetime major depressive episode herald a chronic course of illness?

          This study investigated the influence of incomplete recovery from first lifetime major depressive episodes on long-term outcome. After their first lifetime major depressive episode, patients were divided into asymptomatic (N=70) and residual subthreshold depressive symptom (N=26) recovery groups and compared on longitudinal course during up to 12 years of prospective naturalistic follow-up. Patients with residual subthreshold depressive symptoms during recovery had significantly more severe and chronic future courses. Those with residual symptoms relapsed to major and minor depressive episodes faster and had more recurrences, shorter well intervals, and fewer symptom-free weeks during follow-up than asymptomatic patients. Resolution of major depressive episodes with residual subthreshold depressive symptoms, even the first lifetime episode, appears to be the first step of a more severe, relapsing, and chronic future course. When ongoing subthreshold symptoms continue after major depressive episodes, the illness is still active, and continued treatment is strongly recommended.
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            Remission, dropouts, and adverse drug reaction rates in major depressive disorder: a meta-analysis of head-to-head trials.

            To summarize remission rates and dropouts due to adverse drug reactions (ADRs) or lack of efficacy (LoE) of serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin-reuptake inhibitors (SSRIs), and tricyclic antidepressants (TCAs) in treating major depressive disorder. We searched MEDLINE, EMBASE, IPA, and the Cochrane International Library from 1980-2005. Meta-analysis summarized outcomes from head-to-head randomized clinical trials comparing >or= 2 drugs from three antidepressants classes (SNRIs, and/or SSRIs, and/or TCAs) followed by >or= 6 weeks of treatment. Remission was a final Hamilton Depression Rating Scale (HAMD) score 0.05 for SNRIs versus TCAs; p 0.05 for ADR dropouts only). One limitation was the inclusion of only venlafaxine-XR; results may not be the same for immediate release forms. In addition, few studies reported remission rates. SNRIs had the highest efficacy remission rates (statistically significant for inpatients and outpatients), and the lowest overall dropout rates, suggesting clinical superiority in treating major depression.
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              Lifetime and 12-Month Prevalence of DSM-III-R Disorders in the Chile Psychiatric Prevalence Study

                Author and article information

                Journal
                rmc
                Revista médica de Chile
                Rev. méd. Chile
                Sociedad Médica de Santiago (Santiago, , Chile )
                0034-9887
                September 2008
                : 136
                : 9
                : 1147-1154
                Affiliations
                [02] orgnameUniversity of Toronto orgdiv1, Leslie Dan Faculty of Pharmacy orgdiv2Department of Pharmacy Administration Canadá
                [01] Santiago orgnameUniversidad de Chile orgdiv1Facultad de Ciencias Químicas y Farmacéuticas orgdiv2Departamento de Ciencia y Tecnología Farmacéutica Chile mjiron@ 123456ciq.uchile.cl
                Article
                S0034-98872008000900009 S0034-9887(08)13600909
                10.4067/S0034-98872008000900009
                d6d1fcae-b3ad-4c7d-8e63-2cc71114be56

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 02 May 2008
                : 06 December 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 8
                Product

                SciELO Chile

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                ARTICULOS DE INVESTIGACION

                Antidepressive agents,Fluoxetine,Mood disorders
                Antidepressive agents, Fluoxetine, Mood disorders

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