The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries

Gernot Fugger; Lucie Bartova; Chiara Fabbri; Giuseppe Fanelli; Markus Dold; Marleen Margret Mignon Swoboda; Alexander Kautzky; Joseph Zohar; Daniel Souery; Julien Mendlewicz; Stuart Montgomery; Dan Rujescu; Alessandro Serretti; Siegfried Kasper

doi:10.1007/s00406-021-01368-3

The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries

Gernot Fugger, Lucie Bartova, Chiara Fabbri, Giuseppe Fanelli, Markus Dold, Marleen Margret Mignon Swoboda, Alexander Kautzky, Joseph Zohar, Daniel Souery, Julien Mendlewicz, Stuart Montgomery, Dan Rujescu, Alessandro Serretti, Siegfried Kasper

Social Genetic & Developmental Psychiatry

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Medical University of Vienna
Sheba Medical Center
School of Medicine, Free University of Brussels, Brussels, Belgium.; Psy Pluriel-European Centre of Psychological Medicine, Brussels, Belgium.
School of Medicine, Free University of Brussels, Brussels, Belgium.
1Department of Hepatology, Imperial College London, London, UK. 2Institute of Liver Studies at King's College School of Medicine at King's College Hospital, London, UK. 3Institute of Human Health and Performance, University College London, London, UK. 4Department of Asthma Allergy and Lung Biology, King's College London, London, UK. 5Division of Critical Care Medicine, University of Alberta, Edmonton, Canada.
University of Bologna
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria. [email protected].; Center for Brain Research, Medical University of Vienna, Spitalgasse 4, 1090, Vienna, Austria. [email protected].

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

Abstract

Due to favorable antidepressant (AD) efficacy and tolerability, selective-serotonin reuptake inhibitors (SSRIs) are consistently recommended as substances of first choice for the treatment of major depressive disorder (MDD) in international guidelines. However, little is known about the real-world clinical correlates of patients primarily prescribed SSRIs in contrast to those receiving alternative first-line ADs. These secondary analyses are based on a naturalistic, multinational cross-sectional study conducted by the European Group for the Study of Resistant Depression at ten research sites. We compared the socio-demographic and clinical characteristics of 1410 patients with primary MDD, who were either prescribed SSRIs or alternative substances as first-line AD treatment, using chi-squared tests, analyses of covariance, and logistic regression analyses. SSRIs were prescribed in 52.1% of MDD patients who showed lower odds for unemployment, current severity of depressive symptoms, melancholic features, suicidality, as well as current inpatient treatment compared to patients receiving alternative first-line ADs. Furthermore, patients prescribed SSRIs less likely received add-on therapies including AD combination and augmentation with antipsychotics, and exhibited a trend towards higher response rates. A more favorable socio-demographic and clinical profile associated with SSRIs in contrast to alternative first-line ADs may have guided European psychiatrists' treatment choice for SSRIs, rather than any relevant pharmacological differences in mechanisms of action of the investigated ADs. Our results must be cautiously interpreted in light of predictable biases resulting from the open treatment selection, the possible allocation of less severely ill patients to SSRIs as well as the cross-sectional study design that does not allow to ascertain any causal conclusions. [Abstract copyright: © 2022. The Author(s).]

Original language	English
Pages (from-to)	715-727
Number of pages	13
Journal	European archives of psychiatry and clinical neuroscience
Volume	272
Issue number	4
Early online date	6 Jan 2022
DOIs	https://doi.org/10.1007/s00406-021-01368-3
Publication status	Published - Jun 2022

Keywords

Selective-serotonin reuptake inhibitors
Antidepressant treatment
Antidepressants
Major depressive disorder

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10.1007/s00406-021-01368-3

Cite this

Fugger, G., Bartova, L., Fabbri, C., Fanelli, G., Dold, M., Swoboda, M. M. M., Kautzky, A., Zohar, J., Souery, D., Mendlewicz, J., Montgomery, S., Rujescu, D., Serretti, A., & Kasper, S. (2022). The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries. European archives of psychiatry and clinical neuroscience, 272(4), 715-727. https://doi.org/10.1007/s00406-021-01368-3

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title = "The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries",

abstract = "Due to favorable antidepressant (AD) efficacy and tolerability, selective-serotonin reuptake inhibitors (SSRIs) are consistently recommended as substances of first choice for the treatment of major depressive disorder (MDD) in international guidelines. However, little is known about the real-world clinical correlates of patients primarily prescribed SSRIs in contrast to those receiving alternative first-line ADs. These secondary analyses are based on a naturalistic, multinational cross-sectional study conducted by the European Group for the Study of Resistant Depression at ten research sites. We compared the socio-demographic and clinical characteristics of 1410 patients with primary MDD, who were either prescribed SSRIs or alternative substances as first-line AD treatment, using chi-squared tests, analyses of covariance, and logistic regression analyses. SSRIs were prescribed in 52.1% of MDD patients who showed lower odds for unemployment, current severity of depressive symptoms, melancholic features, suicidality, as well as current inpatient treatment compared to patients receiving alternative first-line ADs. Furthermore, patients prescribed SSRIs less likely received add-on therapies including AD combination and augmentation with antipsychotics, and exhibited a trend towards higher response rates. A more favorable socio-demographic and clinical profile associated with SSRIs in contrast to alternative first-line ADs may have guided European psychiatrists' treatment choice for SSRIs, rather than any relevant pharmacological differences in mechanisms of action of the investigated ADs. Our results must be cautiously interpreted in light of predictable biases resulting from the open treatment selection, the possible allocation of less severely ill patients to SSRIs as well as the cross-sectional study design that does not allow to ascertain any causal conclusions. [Abstract copyright: {\textcopyright} 2022. The Author(s).]",

keywords = "Selective-serotonin reuptake inhibitors, Antidepressant treatment, Antidepressants, Major depressive disorder",

author = "Gernot Fugger and Lucie Bartova and Chiara Fabbri and Giuseppe Fanelli and Markus Dold and Swoboda, {Marleen Margret Mignon} and Alexander Kautzky and Joseph Zohar and Daniel Souery and Julien Mendlewicz and Stuart Montgomery and Dan Rujescu and Alessandro Serretti and Siegfried Kasper",

note = "Funding Information: Dr. Bartova has received travel grants and consultant/speaker honoraria from AOP Orphan, Medizin Medien Austria, Vertretungsnetz, Schwabe Austria, Janssen and Angelini. Dr. Fugger has received consultant/speaker honoraria from Janssen. Dr. Dold has received travel grants and consultant/speaker honoraria from Janssen-Cilag. Dr. Zohar has received grant/research support from Lundbeck, Servier, and Pfizer; he has served as a consultant or on the advisory boards for Servier, Pfizer, Solvay, and Actelion; and he has served on speakers{\textquoteright} bureaus for Lundbeck, GlaxoSmithKline, Jazz, and Solvay. Dr. Mendlewicz is a member of the board of the Lundbeck International Neuroscience Foundation and of the advisory board of Servier. Dr. Souery has received grant/research support from GlaxoSmithKline and Lundbeck; and he has served as a consultant or on advisory boards for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, and Lundbeck. Dr. Montgomery has served as a consultant or on advisory boards for AstraZeneca, Bionevia, Bristol-Myers Squibb, Forest, GlaxoSmithKline, Grunenthal, Intellect Pharma, Johnson & Johnson, Lilly, Lundbeck, Merck, Merz, M's Science, Neurim, Otsuka, Pierre Fabre, Pfizer, Pharmaneuroboost, Richter, Roche, Sanofi, Sepracor, Servier, Shire, Synosis, Takeda, Theracos, Targacept, Transcept, UBC, Xytis, and Wyeth. Dr. Fabbri has been supported by Fondazione Umberto Veronesi ( https://www.fondazioneveronesi.it ). Dr. Serretti has served as a consultant or speaker for Abbott, Abbvie, Angelini, AstraZeneca, Clinical Data, Boehringer, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Innovapharma, Italfarmaco, Janssen, Lundbeck, Naurex, Pfizer, Polifarma, Sanofi, and Servier. Within the last three years, Dr. Kasper received grants/research support, consulting fees, and/or honoraria from Angelini, Celegne GmbH, Eli Lilly, Janssen-Cilag Pharma GmbH, KRKA-Pharma, Lundbeck A/S, Mundipharma, Neuraxpharm, Pfizer, Sanofi, Schwabe, Servier, Shire, Sumitomo Dainippon Pharma Co. Ltd., sun Pharma and Takeda. All other authors declare that they have no conflicts of interest. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = jun,

doi = "10.1007/s00406-021-01368-3",

language = "English",

volume = "272",

pages = "715--727",

journal = "European archives of psychiatry and clinical neuroscience",

issn = "1433-8491",

publisher = "Springer Verlag",

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}

Fugger, G, Bartova, L, Fabbri, C, Fanelli, G, Dold, M, Swoboda, MMM, Kautzky, A, Zohar, J, Souery, D, Mendlewicz, J, Montgomery, S, Rujescu, D, Serretti, A & Kasper, S 2022, 'The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries', European archives of psychiatry and clinical neuroscience, vol. 272, no. 4, pp. 715-727. https://doi.org/10.1007/s00406-021-01368-3

The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries. / Fugger, Gernot; Bartova, Lucie; Fabbri, Chiara et al.
In: European archives of psychiatry and clinical neuroscience, Vol. 272, No. 4, 06.2022, p. 715-727.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries

AU - Fugger, Gernot

AU - Bartova, Lucie

AU - Fabbri, Chiara

AU - Fanelli, Giuseppe

AU - Dold, Markus

AU - Swoboda, Marleen Margret Mignon

AU - Kautzky, Alexander

AU - Zohar, Joseph

AU - Souery, Daniel

AU - Mendlewicz, Julien

AU - Montgomery, Stuart

AU - Rujescu, Dan

AU - Serretti, Alessandro

AU - Kasper, Siegfried

N1 - Funding Information: Dr. Bartova has received travel grants and consultant/speaker honoraria from AOP Orphan, Medizin Medien Austria, Vertretungsnetz, Schwabe Austria, Janssen and Angelini. Dr. Fugger has received consultant/speaker honoraria from Janssen. Dr. Dold has received travel grants and consultant/speaker honoraria from Janssen-Cilag. Dr. Zohar has received grant/research support from Lundbeck, Servier, and Pfizer; he has served as a consultant or on the advisory boards for Servier, Pfizer, Solvay, and Actelion; and he has served on speakers’ bureaus for Lundbeck, GlaxoSmithKline, Jazz, and Solvay. Dr. Mendlewicz is a member of the board of the Lundbeck International Neuroscience Foundation and of the advisory board of Servier. Dr. Souery has received grant/research support from GlaxoSmithKline and Lundbeck; and he has served as a consultant or on advisory boards for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, and Lundbeck. Dr. Montgomery has served as a consultant or on advisory boards for AstraZeneca, Bionevia, Bristol-Myers Squibb, Forest, GlaxoSmithKline, Grunenthal, Intellect Pharma, Johnson & Johnson, Lilly, Lundbeck, Merck, Merz, M's Science, Neurim, Otsuka, Pierre Fabre, Pfizer, Pharmaneuroboost, Richter, Roche, Sanofi, Sepracor, Servier, Shire, Synosis, Takeda, Theracos, Targacept, Transcept, UBC, Xytis, and Wyeth. Dr. Fabbri has been supported by Fondazione Umberto Veronesi ( https://www.fondazioneveronesi.it ). Dr. Serretti has served as a consultant or speaker for Abbott, Abbvie, Angelini, AstraZeneca, Clinical Data, Boehringer, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Innovapharma, Italfarmaco, Janssen, Lundbeck, Naurex, Pfizer, Polifarma, Sanofi, and Servier. Within the last three years, Dr. Kasper received grants/research support, consulting fees, and/or honoraria from Angelini, Celegne GmbH, Eli Lilly, Janssen-Cilag Pharma GmbH, KRKA-Pharma, Lundbeck A/S, Mundipharma, Neuraxpharm, Pfizer, Sanofi, Schwabe, Servier, Shire, Sumitomo Dainippon Pharma Co. Ltd., sun Pharma and Takeda. All other authors declare that they have no conflicts of interest. Publisher Copyright: © 2022, The Author(s).

PY - 2022/6

Y1 - 2022/6

N2 - Due to favorable antidepressant (AD) efficacy and tolerability, selective-serotonin reuptake inhibitors (SSRIs) are consistently recommended as substances of first choice for the treatment of major depressive disorder (MDD) in international guidelines. However, little is known about the real-world clinical correlates of patients primarily prescribed SSRIs in contrast to those receiving alternative first-line ADs. These secondary analyses are based on a naturalistic, multinational cross-sectional study conducted by the European Group for the Study of Resistant Depression at ten research sites. We compared the socio-demographic and clinical characteristics of 1410 patients with primary MDD, who were either prescribed SSRIs or alternative substances as first-line AD treatment, using chi-squared tests, analyses of covariance, and logistic regression analyses. SSRIs were prescribed in 52.1% of MDD patients who showed lower odds for unemployment, current severity of depressive symptoms, melancholic features, suicidality, as well as current inpatient treatment compared to patients receiving alternative first-line ADs. Furthermore, patients prescribed SSRIs less likely received add-on therapies including AD combination and augmentation with antipsychotics, and exhibited a trend towards higher response rates. A more favorable socio-demographic and clinical profile associated with SSRIs in contrast to alternative first-line ADs may have guided European psychiatrists' treatment choice for SSRIs, rather than any relevant pharmacological differences in mechanisms of action of the investigated ADs. Our results must be cautiously interpreted in light of predictable biases resulting from the open treatment selection, the possible allocation of less severely ill patients to SSRIs as well as the cross-sectional study design that does not allow to ascertain any causal conclusions. [Abstract copyright: © 2022. The Author(s).]

AB - Due to favorable antidepressant (AD) efficacy and tolerability, selective-serotonin reuptake inhibitors (SSRIs) are consistently recommended as substances of first choice for the treatment of major depressive disorder (MDD) in international guidelines. However, little is known about the real-world clinical correlates of patients primarily prescribed SSRIs in contrast to those receiving alternative first-line ADs. These secondary analyses are based on a naturalistic, multinational cross-sectional study conducted by the European Group for the Study of Resistant Depression at ten research sites. We compared the socio-demographic and clinical characteristics of 1410 patients with primary MDD, who were either prescribed SSRIs or alternative substances as first-line AD treatment, using chi-squared tests, analyses of covariance, and logistic regression analyses. SSRIs were prescribed in 52.1% of MDD patients who showed lower odds for unemployment, current severity of depressive symptoms, melancholic features, suicidality, as well as current inpatient treatment compared to patients receiving alternative first-line ADs. Furthermore, patients prescribed SSRIs less likely received add-on therapies including AD combination and augmentation with antipsychotics, and exhibited a trend towards higher response rates. A more favorable socio-demographic and clinical profile associated with SSRIs in contrast to alternative first-line ADs may have guided European psychiatrists' treatment choice for SSRIs, rather than any relevant pharmacological differences in mechanisms of action of the investigated ADs. Our results must be cautiously interpreted in light of predictable biases resulting from the open treatment selection, the possible allocation of less severely ill patients to SSRIs as well as the cross-sectional study design that does not allow to ascertain any causal conclusions. [Abstract copyright: © 2022. The Author(s).]

KW - Selective-serotonin reuptake inhibitors

KW - Antidepressant treatment

KW - Antidepressants

KW - Major depressive disorder

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U2 - 10.1007/s00406-021-01368-3

DO - 10.1007/s00406-021-01368-3

M3 - Article

C2 - 34989830

SN - 1433-8491

VL - 272

SP - 715

EP - 727

JO - European archives of psychiatry and clinical neuroscience

JF - European archives of psychiatry and clinical neuroscience

IS - 4

ER -

The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries

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