Non-interventional, Retrospective Cohort Study to Explore Antidepressant Treatment in Korea

While there are many antidepressants from which physicians can select based on efficacy and tolerability profile, evidence on effectiveness and safety outcomes of new antidepressants in real clinical practice among Korean MDD population is limited.

Hence, this study will explore the following primary, secondary objectives using national health insurance database :

1. Explore baseline characteristics and drug utilization patterns of 11 commonly used antidepressant therapy during 90 days of acute treatment phase
2. Explore drug utilization patterns such as therapy changes, medication compliance and recurrence relationship, and risk of adverse outcomes during maintenance phase
3. Choice of antidepressants and drug utilization patterns in patients with various comorbidities
4. The relationship of non-pharmacologic treatment and discontinuation, medication compliance
5. Choice of antidepressants by non-psychiatric specialty

• Drug: Escitalopram
  Treatment for depression
• Drug: Paroxetine
  Treatment for depression
• Drug: Fluoxetine
  Treatment for depression
• Drug: Mirtazapine
  Treatment for depression
• Drug: Duloxetine
  Treatment for depression
• Drug: Sertraline
  Treatment for depression
• Drug: Venlafaxine
  Treatment for depression
• Drug: Tianeptine
  Treatment for depression
• Drug: Vortioxetine
  Treatment for depression
• Drug: Desvenlafaxine
  Treatment for depression
• Drug: Bupropion
  Treatment for depression

• 1. Escitalopram Cohort
  Intervention: Drug: Escitalopram
• 2. Paroxetine Cohort
  Intervention: Drug: Paroxetine
• 3. Fluoxetine Cohort
  Intervention: Drug: Fluoxetine
• 4. Mirtazapine Cohort
  Intervention: Drug: Mirtazapine
• 5. Duloxetine Cohort
  Intervention: Drug: Duloxetine
• 6. Sertraline Cohort
  Intervention: Drug: Sertraline
• 7. Venlafaxine Cohort
  Intervention: Drug: Venlafaxine
• 8. Tianeptine Cohort
  Intervention: Drug: Tianeptine
• 9. Vortioxetine Cohort
  Intervention: Drug: Vortioxetine
• 10. Desvenlafaxine Cohort
  Intervention: Drug: Desvenlafaxine
• 11. Bupropion Cohort
  Intervention: Drug: Bupropion

Inclusion Criteria

Patients must meet all of the following inclusion criteria to be eligible for inclusion in the study:

1. Patients aged 18 years or older on the index date
2. Patients who had at least one inpatient claim or two outpatient claims in the intake period with any of the following diagnosis codes F06.3 Organic mood [affective] disorders F32* Depressive episode F33* Recurrent depressive disorder F34.1 Neurotic depression F38.1 Other recurrent mood [affective] disorder F41.2 Mixed anxiety and depressive disorder
3. Patients prescribed any of the following antidepressant during intake period (from January 1, 2017 to June 30, 2018)

Exclusion Criteria

Patients meeting any of the following criteria will not be included in the study:

1. Patients with a claim of diagnosis codes in Table 1 during the 12 month pre-index period
2. Patients with a claim of prescription in Table 2 during the 12 month pre-index period
3. Patient who had a claim as a beneficiary of Medical Aid program (Korean Medicaid program with free or minimum copay)
4. Patients who are hospitalized at the index date
5. Patients who are under hospice care (procedure codes WG*-WO*)