gms | German Medical Science

16. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

19.11. - 20.11.2009, Berlin

Is there a correlation between hormone therapy and the prescription of antidepressants?

Meeting Abstract

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  • corresponding author C. Gerdau-Heitmann - Universität Bremen, Zentrum für Sozialpolitik ZeS, Bremen, Germany
  • G. Glaeske - Universität Bremen, Zentrum für Sozialpolitik ZeS, Bremen, Germany
  • K. Janhsen - Universität Bremen, Zentrum für Sozialpolitik ZeS, Bremen, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 16. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Berlin, 19.-20.11.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09gaa19

DOI: 10.3205/09gaa19, URN: urn:nbn:de:0183-09gaa192

Veröffentlicht: 5. November 2009

© 2009 Gerdau-Heitmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background and aim: Since the results of the Women Health Initiative (WHI) and the Million Women Study (MWS) had been published in 2002/2003 the prescription of Hormone medicals registered for peri- and postmenopausal therapy decreased in Germany. Nearly at the same time the prescription of Antidepressants has increased. The aim of this study is to clarify if there is a correlation and/or is there a difference between women with Hormone Therapy (HT) and those without HT.

Material and method: For the following analysis secondary data of the Gmünder ErsatzKasse (GEK) was used. This data was related to individuals but non-identifying. The choice of the medicals that were taken into consideration were in accordance with the ATC-Code (ATC = Anatomical Therapeutic Chemical Code). Outpatient data was used to identify patients with depression and/or psychotherapy. Only data of women who were insured the whole time in 2007 and were aged between 40 and below 100 were taken into account. The analysis was done by using SAS Statistic program.

Results: 338.055 women were permanently insured in 2007 and between 40 and <100 years of age. Of those 43.401 got a prescription of HT. Women taking HT had more diagnoses of depression and a higher prescription prevalence of antidepressants. And these women got also more psychotherapy than women not taking HT.

It is demonstrated that the prevalence of depression plus a prescription of antidepressants increased by age for women without HT. Women taking HT showed a stagnation of this prevalence during the climacteric period.

Regarding the subgroups of antidepressants we found out that Selective Serotonin Reuptake Inhibitors (SSRI) were less prescribed than Tricyclic Antidepressants (TCA) for women taking HT. Higher SSRI prescription rates can be stated for women not taking HT and who were older (70+).

Conclusions: Women taking HT got more prescriptions of antidepressants and more psychotherapy but had also more diagnoses of depression. It is shown that the prevalence of depression plus a prescription of antidepressants increased with age in women not taking HT. Women taking HT had an increased rate until the age of 55 than it stagnated up to 70 years of age and after this it increased again. Contrary to German recommendation Psychotherapy is only marginal prescribed and particularly for older women.

With regard to the subgroups of antidepressants it can be stated that women taking HT had less prescriptions of SSRI’s and therefore more of TCA which are discussed to have more side-effects especially on older women. SSRI’s show a higher prescription prevalence for women taking not HT and were older (70+). This was not expected because for SSRI’s it is described in the literature that high estriol levels are necessary for the effectiveness of SSRI’s.

Women with depression should get more psychotherapy and for the prescription of antidepressants hormone levels and also hormone medication should be taken into account.