Patrones de prescripción de antidepresivos en pacientes afiliados al Sistema General de Seguridad Social en Salud de Colombia

objective: determine patterns of antidepressive drug prescription in a group of patients affiliated with the general social security health system in colombia. methods: observational descriptive study of 9 881 patients, of both sexes and older than 5 years of age, medicated with antidepressants and continuously treated from august to october 2009. the patients include residents from 56 colombian cities. a database was designed based on the consumption of medicines obtained from the company that distributes them to the patients. results: the average age was 59.1 ± 16.1 years; 73.7% of the participants were women. of the total number of patients, 83.3% were treated with monotherapy and 16.7% with two or more antidepressants. the order of the prescription of the medicines was: selective serotonin reuptake inhibitors, 47.0%; atypical, 37.8%; tricyclical, 31.8%; selective serotonin reuptake inhibitors and norepinephrine, 1.8%; and selective norepinephrine reuptake inhibitors, 0.03%. the combinations most used were fluoxetine + trazodone (n = 1 029); amitriptyline + fluoxetine (n = 265); amitriptyline + trazodone (n = 122); fluoxetine + imipramine (n = 106); and imipramine + trazodone (n = 71). the most prescribed co-medications were anti-hypertensives (52.3%); thyroid hormones (23.3%); anti-inflammatories (19.6%); anti-epileptics (15.4%); anti-diabetics (13.8%); anti-anxiety and hypnotics (12.4%); antipsychotics (7.4%); anti-parkinsons (4.3%); and anti-neoplastics (2.2%). conclusions: the practice of prescribing medicines with a high therapeutic value predominates, mainly for antidepressive monotherapy. most of the antidepressants are prescribed at dosages lower than those recommended. there is a need to design educational strategies to correct some prescription practices and to conduct research