Aim To determine the prevalence of depressive episodes and recurrent depressive disorders despite of the length of therapy and type of antidepressants. Methods The study was conducted among 508 patients aged 19-65 years who were treated for depression for at least 3 months (mild and moderate episodes were controlled and the effects of treatment monitored by family physicians, while severe episodes were controlled by a psychiatrist) during 2013- 2015 in Zenica-Doboj Canton using the Hamilton Depression Rating Scale (HDRS). Results The average age of the patients was 48.98±11.585 years. Depressive disorder was most commonly represented in patients with high-level education, 22%, more frequently in non-productive workers (non-productive vs. manufacturing 58%:35%). A significant number of patients who were treated for depression were unemployed (57%). All respondents were suffering from the most serious episode of depression with an average depression rate at the Hamilton scale 18.49±8.603, with a very serious depression level of 32%, severe 17%, moderate 21%, and mild 20%. Most patients were treated with paroxetine, 27%, fluoxetine 22% and sertraline 17%. Efficacy of depression treatment with different types of selective serotonin reuptake inhibitors antidepressants (SSRIs) was not significantly different (p=0.502). Conclusion Success of the treatment with the absence of symptoms of depression was achieved in 10% and the maintenance of depressive episodes occurred in 90% of cases. Adverse reactions with the most commonly prescribed SSRI in our country should be important in creating procedures and strategies for the future treatment of depression in family medicine.
Kessler RC, Ormel J, Petukhova M, McLaughlin KA, Green JG, Russo LJ, et al. Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry. 2011;68(90).
2.
Sutherland JE, Sutherland AJ, Hoehns D. Achieving the best outcome in treatment of depression. J Fam Pract. 2003;59:203–10.
3.
Turner EH, Matthews AM, Linardatos E, Tell A, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med. 2008;358:252–60.
4.
Nelson JC, Devanand DP. A systematic review and meta-analysis of placebo controlled antidepressant studies in people with depression and dementia. J Am Geriatr Soc. 2011;59:203–10.
5.
P GSW, J G, R T. Educational and organisational interventions to improve the management of depression in primary care: a systematic review. JAMA. 2003;289:3145–51.
6.
Trumić E, Pranjić N, Begić L, Bečić F. Prevalence of polypharmacy and drug interaction among hospitalized patients: Opportunities and responsibilities in pharmaceutical care. Mat Soc Med. 2012;24:68–72.
7.
Zavod za javno zdravstvo Federacije Bosne i Hercegovine, Sarajevo. Zdravstveno stanje stanovništva. 2009;
8.
M JG, N MB, A J, S PN. Antidepresivi. 2012.
9.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.
10.
Bertolote JM, Fleischmann A, Leo D, Wasserman D. Psychiatric diagnoses and suicide: revisiting the evidence. Crisis. 2004;25:147–55.
11.
Gunnel D, Saperia J, Ashby D. Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults; meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA’s safety review. 2005;330(385).
12.
Khan A, Khan S, Russell LK, Brown W. Suicide rates in clinical trials of SSRIs, other antidepressants, and placebo: analysis of FDA reports. Am J Psychiatry. 2003;160:790–2.
13.
Bostwick JM, Pankratz VS. Affective disorders and suicide risk: a re-examination. Am J Psychiatry. 2000;157:1925–32.
14.
Pranjić N, Bajraktarević A. Depression and suicide ideation among secondary school adolescents involved in school bullyng. Prim Health Care Res Dev. 2010;11:349–62.
15.
National Institute for Health Care Excellence-NICE. Depression in adults: recognition and management. 2009;
16.
Cuijpers P, Dekker J, Hollon SD, Andersson G. Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: a metaanalysis. J Clin Psychiatry. 2009;70:1219–24.
17.
Rush AJ, Trivedi MH, Wisniewski N, AA S, JW W, D N, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163:1905–17.
Anderson IM. SSRIs versus tricyclic antidepressants in depressed patients: meta-analysis of efficacy and tolerability. Depress Anxiety. 1998;7:11–7.
20.
Bymaster FP, Zhang W, Carter PA, Shaw J, Chernet E, Phebus L, et al. Fluoxetine, but not other selective serotonin uptake inhibitors, increases norepinephrine and dopamine extracellular levels in prefrontal cortex. Psychopharmacology. 2002;160:353–61.
21.
Edvrds JG, Anderson I. Systematic review and guide to selection of selective serotonin reuptake inhibitors. Drags. 1999;58:1207–58.
22.
Kupfer DJ, Frank E, Phillips ML. Major depressive disorder: new clinical, neurobiological, and treatment perspectives. Lancet. 2012;379:1045–9.
23.
Ferguson JM. Antidepressant medications: adverse effects and tolerability. Prim Care Companion J Clin Psych. 2001;3:22–7.
24.
Cuijpers P, Straten A, Warmerdam L, Andersson G. Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis. Depress Anxiety. 2009;26:279–88.
25.
Jašović-Gašić M, Damjanović A, Miljević Č, Marić N. Antidepresivi. 2006.
26.
Jašović-Gašić M, Damjanović A, Miljević Č, Marić N. Antidepresivi. 2000.
27.
Sussman N, Ginsber D. Rethinking side effects of the selective serotonin reuptake inhibitors: sexual dysfunction and weight gain. Psychiatr Ann. 1998;28:89–97.
28.
Eitan R. Nonpharmacological, somatic treatmens of depression: electroconvulsive therapy and novel brain stimulation modalities. Dialogus Clin Neurose. 2006;8:235–43.
29.
Sotsky SM, Glass DR, Shea MT, Pilkonis PA, Collins JF, Elkin I, et al. Patient predictors of response to psychotherapy and pharmacotherapy: findings in the NIMH Treatment of Depression Collaborative Research Program. Am J Psychiatry1991. 148:997–1008.
30.
Geddes C, SM D, C F, TA K, DJ F, E G, et al. Relapse prevention with antidepressant drug treatment in depressive disorders. Lancet. 2003;361:653–61.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.