![]() ĭespite, literally, thousands of randomized clinical trials, a great deal about the effectiveness of antidepressants is still not known, primarily because the size and composition of randomized trials limit subgroup analysis. As a consequence, it is not surprising that late-life depression has the highest mortality among all chronic comorbidities. Depression can affect compliance with medication patients may abandon effective medical treatment. Poor treatment of depression worsens medical outcomes, increases the risk of suicide, increases disability, hastens cognitive decline/dementia, increases falls/injuries, and causes drug-drug interactions, and wastes health care resources. Future studies can use the procedures described here to organize studies of the comparative effectiveness of antidepressants. A surrogate measure for self-reported symptom remission based on the patterns of use of antidepressants has been proposed to address the absence of outcomes in claims. ![]() In 10,221,145 episodes, within the first 100 days of start of the episode, 4,729,372 (46.3%) continued their treatment, 1,306,338 (12.8%) switched to another medication, 3,586,156 (35.1%) discontinued their medication, and 599,279 (5.9%) augmented their treatment.Ĭonclusions: We present a procedure for constructing a cohort using claims data. The mean age of the cohort was 46.54 years (standard deviation of 17.48) at first prescription of antidepressant, which was also the enrollment event (16.92% were over 65 years), and most were female (69.36%). Results: The average follow-up was 2.93 years, resulting in 15,096,055 person-years of data. Follow-up was passive, automatic, and collated from fragmented clinical services of diverse providers. Patients who had no utilization of health services for at least two years, or who had died, were excluded from the analysis. A total of 10,221,145 antidepressant treatment episodes were analyzed. Methods: The cohort includes experiences of 3,678,082 patients with depression in the United States on antidepressants between January 1, 2001, and December 31, 2018. Purpose: The study reports the construction of a cohort used to study the effectiveness of antidepressants.
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