Visualizing patterns of medication switching among major depressive patients with various stability and difficulty to treatments

Yu Chun Hung, Hsi Chung Chen, Po Hsiu Kuo, Mong Liang Lu, Ming Chyi Huang, Chun Hsin Chen, Sabrina Wang, Wei Chung Mao, Chang Shiann Wu, Tzu Hua Wu

研究成果: 雜誌貢獻文章同行評審

摘要

Introduction: Efforts have been made in assessing efficacy and tolerability to various antidepressants, but understanding personalized chances of stability to medication switching sequence is still inconclusive. This study aimed to identify naturalistic switching patterns of medication in stratifying MDD patients. Methods: MDD patients were stratified based on treatment difficulty evaluated with the “Treatment Resistance to Antidepressants Evaluation Scale for Unipolar Depression” (TRADES). The duration of the time of diagnoses until the final switch to another class of antidepressants was used as prediction of unstable to drug therapy. ROC analysis was used to determine the cutoff values. A continuous temporal events function from the visual analytic tool was employed to perform patterns of switching between distinct pharmacological class such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reup-take inhibitors (SNRIs). Results: TRADES scores of 4.5 and not-switching times of 12.5 months were used as cutoff values to divide patients into four subgroups: stable/easy-to-treat (SE), unstable/easy-to-treat (UE), stable/difficult-to-treat (SD) and unstable/difficult-to-treat (UD). A total of 80% and 76.9% of patients initially treated with the SSRIs paroxetine or fluoxetine, respectively, were predicted to be stable to drug therapy. Approximately 70%, 44.8% and 41.4% of patients initially treated with the SNRIs fluvoxamine, sertraline and venlafaxine, respectively, were predicted to be UD, and 60% of patients using duloxetine were predicted to be stable to drug therapy. Analysis of the switching phenomenon showed that SSRIs were the first prescribed medications and mostly taken by the stable subgroups, and SNRIs were the preferentially chosen switching alternative. Medication switching patterns in unstable MDD patients are discussed. Conclusion: Paroxetine, fluoxetine and duloxetine users were mostly stable among MDD patients in Taiwan with various stability and difficulty to treatments. Although responsive-ness to specific medication sequence is likely required for clinical application, the results provide a baseline for such studies.

原文英語
頁(從 - 到)1953-1963
頁數11
期刊Neuropsychiatric Disease and Treatment
17
DOIs
出版狀態已發佈 - 2021

ASJC Scopus subject areas

  • 精神病學和心理健康
  • 生物精神病學

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