Table 1.
Baseline Patient Characteristicsa
| Patient Characteristic |
SSRIsb | SSRIs, Total |
SNRIsb | MAOIsc | Other Newer and Atypical Agentsc |
TCAsc | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Citalopram | Fluoxetine | Fluvoxamine | Paroxetine | Sertraline | ||||||
| Total users, No. | 45 522 | 22 207 | 9690 | 74 780 | 36 135 | 188 334 | 35 732 | 1751 | 28 316 | 33 410 |
| Demographic characteristics |
||||||||||
| Age, mean (SD), y |
46.7 (18.4) | 41.9 (14.9) | 48.0 (18.0) | 46.1 (17.6) | 46.3 (17.7) | 45.9 (17.6) | 43.3 (16.1) | 48.6 (17.4) | 47.3 (16.4) | 48.8 (16.4) |
| Female, No. (%) | 25749 (56.6) | 12779 (57.5) | 5466 (56.4) | 42 092 (56.3) | 21 861 (60.5) | 107 947 (57.3) | 18396 (51.5) | 995 (56.8) | 14 290 (50.5) | 20 001 (59.9) |
| Income in Can$, No. (%) |
||||||||||
| <16000 | 7780 (18.1) | 4166 (20.4) | 1798 (20.5) | 13400 (19.3) | 6320 (18.9) | 33464 (19.1) | 6136 (18.4) | 266 (16.6) | 5042 (19.5) | 6731 (22.2) |
| 16 000–28 000 | 2007 (4.7) | 1005 (4.9) | 588 (6.7) | 3905 (5.6) | 1892 (5.7) | 9397 (5.4) | 1494 (4.5) | 91 (5.7) | 1315 (5.1) | 1886 (6.2) |
| >28 000 | 33 099 (77.2) | 15 258 (74.7) | 6388 (72.8) | 52 071 (75.1) | 25165 (75.4) | 131 981 (75.5) | 25 813 (77.2) | 1247 (77.7) | 19 501 (75.4) | 21 753 (71.6) |
| Comorbidities and health services use intensity |
||||||||||
| Distinct generic medications prescribed, mean (SD), No. |
5.5 (4.3) | 4.8 (3.7) | 5.7 (4.3) | 5.4 (4.1) | 5.4 (4.1) | 5.4 (4.1) | 4.9 (3.8) | 5.9 (4.5) | 5.7 (4.3) | 6.7 (4.6) |
| Comorbidity score, mean (SD) |
0.24 (0.85) | 0.14 (0.62) | 0.25 (0.85) | 0.19 (0.74) | 0.21 (0.78) | 0.21 (0.77) | 0.16 (0.69) | 0.31 (0.99) | 0.22 (0.80) | 0.26 (0.86) |
| Psychiatric visit with depression diagnosis, No. (%) |
804 (1.8) | 361 (1.6) | 225 (2.3) | 908 (1.2) | 627 (1.7) | 2925 (1.6) | 681 (1.9) | 100 (5.7) | 675 (2.4) | 473 (1.4) |
| Psychiatric hospitalization, No. (%) |
2297 (5.1) | 771 (3.5) | 626 (6.5) | 3574 (4.8) | 2181 (6.0) | 9449 (5.0) | 1694 (4.7) | 142 (8.1) | 1907 (6.7) | 1368 (4.1) |
| Recorded psychiatric disorders, No. (%)d |
||||||||||
| ADHD | 136 (0.3) | 78 (0.4) | 25 (0.3) | 177 (0.2) | 105 (0.3) | 521 (0.3) | 94 (0.3) | 9 (0.5) | 89 (0.3) | 113 (0.3) |
| Anxiety or sleep disorder |
608 (1.3) | 227 (1.0) | 198 (2.0) | 1269 (1.7) | 536 (1.5) | 2838 (1.5) | 575 (1.6) | 39 (2.2) | 549 (1.9) | 524 (1.6) |
| Dementia | 331 (0.7) | 48 (0.2) | 64 (0.7) | 312 (0.4) | 219 (0.6) | 974 (0.5) | 152 (0.4) | 19 (1.1) | 208 (0.7) | 96 (0.3) |
| Mania | 623 (1.4) | 143 (0.6) | 140 (1.4) | 694 (0.9) | 530 (1.5) | 2130 (1.1) | 569 (1.6) | 42 (2.4) | 489 (1.7) | 171 (0.5) |
| Psychotic disorder |
883 (1.9) | 238 (1.1) | 195 (2.0) | 921 (1.2) | 634 (1.8) | 2871 (1.5) | 543 (1.5) | 22 (1.3) | 673 (2.4) | 382 (1.1) |
| Substance abuse | 971 (2.1) | 547 (2.5) | 311 (3.2) | 1881 (2.5) | 987 (2.7) | 4697 (2.5) | 951 (2.7) | 51 (2.9) | 1404 (5.0) | 1087 (3.3) |
| Suicide attempt | 250 (0.6) | 119 (0.5) | 70 (0.7) | 403 (0.5) | 267 (0.7) | 1109 (0.6) | 236 (0.7) | 15 (0.9) | 231 (0.8) | 121 (0.4) |
| Use of ≥ 1 additional psychiatric medicationse |
13 973 (30.7) | 5453 (24.6) | 3761 (38.8) | 28785 (38.5) | 12190 (33.7) | 64162 (34.1) | 10723 (30.0) | 670 (38.3) | 10 819 (38.2) | 12672 (37.9) |
| Concurrent stimulant use |
99 (0.2) | 58 (0.3) | 18 (0.2) | 107 (0.1) | 64 (0.2) | 346 (0.2) | 83 (0.2) | 8 (0.5) | 47 (0.2) | 61 (0.2) |
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; MAOIs, monoamine oxidase inhibitors; SNRIs, serotonin-norepinephrine reuptake inhibitors; SSRIs, selective serotonin reuptake inhibitors; TCAs, tricyclic agents.
Baseline covariates were assessed during the year prior to treatment initiation.
Citalopram indicates generic citalopram hydrobromide and Celexa; fluoxetine, generic fluoxetine hydrochloride and Prozac; fluvoxamine, generic fluvoxamine maleate and Luvox; paroxetine, generic paroxetine hydrochloride and Paxil; sertraline, generic sertraline hydrochloride and Zoloft; and SNRIs, generic venlafaxine hydrochloride and Effexor.
Class lists are as follows: for MAOIs, moclobemide, phenelzine sulfate, and tranylcypromine sulfate; for other newer and atypical agents, mirtazapine, nefazodone hydrochloride, and trazodone hydrochloride; and for TCAs, amitriptyline hydrochloride, amoxapine, clomipramine hydrochloride, desipramine hydrochloride, doxepin hydrochloride, imipramine hydrochloride, maprotiline hydrochloride, nortriptyline hydrochloride, protriptyline hydrochloride, and trimipramine maleate.
Psychiatric disorders were identified based on the presence of 1 inpatient diagnosis code for the disorder or 2 or more outpatient diagnosis codes.
Additional psychiatric medications exclude stimulants.