Depression Treatment Survey of Psychiatrists: Outcome and Side Effects

Objective: To explore psychiatrists’ opinions on the effectiveness and side-effects of current pharmacological antidepressant treatments in Australia. Method: A postal survey was sent to all consultant psychiatrists in Australia. Results: A total of 412 psychiatrists replied. The mean remission rate for depression reported by the sample was 54%. Following a partial but inadequate response to an optimal dose of either a Selective Serotonin Reuptake Inhibitors (SSRI) or Selective Serotonin/Noradrenaline Reuptake Inhibitors (SNRI), 42% (n=172) of respondents reported they would wash out the initial antidepressant and then start another antidepressant, 26% (n=106) would crosstaper antidepressants and 14% (n=59) would add a second antidepressant. Sexual problems, withdrawals, weight gain, perspiration and emotional blunting were reported as significant side-effects. Conclusion: The psychiatrists surveyed believed that depression in psychiatric practice had a guarded prognosis. Pharmacological agents commonly used for depression are perceived to have inadequate efficacy and a high side-effect burden. With regard to the effectiveness of treatment by family doctors, easier access to psychiatrists and psychologists, and better use of medication were suggested by psychiatrists as likely to improve outcomes for patients.