Pharmacological treatment of depression in primary care: an updated literature review

Objective: undertreatment of depression has been regarded as a major public health problem. Aim of this paper are to evaluate recent data available in literature about the use of AntiDepressants (ADs) in primary care and to define the extent of this problematic area. Method: we conducted a systematic, electronic search of the literature in the following databases: PubMed, PsychInfo and Embase between January 2000 and December 2009. Only observational studies were included. Results: we identified 30 papers. Use of ADs has been increased since 199S to nowadays, across countries. Six studies evaluating the antidepressant treatment rate in primary care attendees with a research diagnosis of depression found a rate ranging 21-65%. The rate of early discontinuation treatment, "occasional prescription", varies within the considered studies between 7-66%. Four studies provide data about 6 months treatment: overall the rate of discontinuation treatments at 6 months vary between 41.0-63.0%. Conclusions: data presented in this review seems to demonstrate an increased appropriateness in depression treatment in primary care. New generation ofADs have favoured treatment of depression for not-psychiatric physicians. Duration of pharmacological treatment is still often inadequate.