Depression is common and is estimated to affect 1 in 20 Australians each year.
In 2013–14, there were 14,933,534 PBS prescriptions dispensed for antidepressants, for people aged 18 to 64 years, and 6,592,577 PBS prescriptions for people aged 65 years and over.
This makes it an important therapeutic area where pharmacists can maximise recovery by providing valuable support to patients prescribed an antidepressant.
With a range of supportive, psychological and pharmacological management options available, treatment choices should take patient needs and preferences into account, as well as social and cultural factors.
Selection of an antidepressant will depend on adverse effect profile, potential interactions with concomitant medicines, comorbidities and patient response to previously trialled antidepressants. For the treatment of mild depression, antidepressants are not recommended.
The use of antidepressants should always be part of broader management plans that include follow up and support. Pharmacists are in a pivotal position to collaborate with GPs and other health professionals to reinforce management plans with patients by assessing patient understanding, exploring expectations and/or addressing misconceptions.
A good approach is to ask the patient what they understand about their treatment and address any gaps in knowledge.
When a patient is switching or discontinuing from an antidepressant, highlight the importance of compliance with their recommended switching regime and encourage patients to discuss any discontinuation symptoms. Monitoring for adherence and adverse effects is important at all stages of antidepressant use – initiation, continuation and discontinuation.
Pharmacists can enhance their level of support to people on antidepressants by taking part in the latest NPS MedicineWise Pharmacy Practice Review Depression: Supporting quality use of antidepressants.