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Selective Serotonin Reuptake Inhibitor Type Impacts on Healthcare Use: Presented at ADAA

By Alison Palkhivala

TORONTO, ON -- April 1, 2003 -- The selective serotonin reuptake inhibitor (SSRI) antidepressant chosen to treat depression and anxiety disorders may impact on the degree to which patients use healthcare services, following therapy initiation.

James M. Russell, MD, and colleagues from the University of Texas Medical Branch, Galveston, Texas, collected data on healthcare utilization between 1996 and 1999, using MarketScan Commercial Claims and Encounter Databases (MEDSTAT). The work was done in collaboration with researchers from Pfizer, Inc., manufacturers of sertraline.

Specifically, the researchers collected data on inpatient, outpatient and emergency room usage rates during the six-month period before and after new initiation of the SSRI drugs sertraline, paroxetine and fluoxetine among adults who had received a diagnosis of major depressive disorder or an anxiety disorder within the previous 30 days. Results were presented here in a poster on March 29^th at the 23^rd Annual Conference of the Anxiety Disorders Association of America.

Overall, the investigators identified 181 patients treated with sertraline, 169 treated with fluoxetine and 215 treated with paroxetine. There were no significant differences among these three groups with respect to demographic characteristics or pre-SSRI healthcare utilization. Subjects taking fluoxetine were significantly more likely to have initiated treatment in 1996.

Among sertraline-treated patients, there was a non-significant decrease in depression- or anxiety disorder-related emergency room visits following initiation of therapy (seven before versus three afterward). In contrast, there was a non-significant increase in emergency room use for these indications among fluoxetine patients (three before versus five afterward), and a significant increase among paroxetine patients (one before versus 10 afterward, P<0.05).

All three groups of patients had a non-significant increase in depression- or anxiety disorder-related inpatient use, but only sertraline-treated patients showed a decrease in non-disorder-related inpatient use.

According to the authors, "The results of this study are consistent with previous work that suggests that SSRI choice can affect total healthcare utilization."


[Study title: Changes in Healthcare Utilization by Patients with an Anxiety Disorder and a History of Major Depression after treatment with Sertraline, Fluoxetine or Paroxetine. Abstract 39]

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