الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Depression is a global public health problem affecting people worldwide with major
consequences for being a global burden disease on human health life or reaching to
suicidal level. Antidepressants are among the most commonly prescribed drugs worldwide.
They are not only used for treatment of depression, but also for treatment of anxiety and
irritability, sleep disorders, obsessive compulsive neurosis, post-traumatic psychic
problems, post-operative psychic problems, fear, and sexual problems like premature
ejaculations.
The current study aimed to investigate the pattern of use of antidepressant drugs
purchased at community pharmacies in Giza City, Egypt, and to identify the determinants
of use of antidepressants among their purchasers.
A cross-sectional study was conducted among 601 purchasers of antidepressants in
30 pharmacies across Giza City. A pre-designed structured interviewing questionnaire was
used to collect the following data: socio-demographic characteristics (age, sex, occupation,
residence, marital status and educational level), data about antidepressants intake
(numbers, types, prescriber, purpose of use, frequency of use, duration, and adverse
effects), previous or current psychiatric conditions, and co-morbid medical conditions.
The study revealed the following main results:
Purchasers aged 35 to less than 45 years of age constituted (28.9%) were the highest age
group using antidepressants. Males constituted 63.7% of the purchasers. More than half
of studied purchasers (53.6%) were married. The majority of purchasers (89.8%) were
from urban areas. About half of the studied purchasers (48.9%) had university and
postgraduate education. Non-professionals purchasers constituted 34.6% of the studied
purchasers.
selective serotonin reuptake inhibitors were the most commonly used type of
antidepressants (70.4%), followed by TCAs (17.3%), and atypical antidepressants
(14.9%). Herbal antidepressants and SNRIs constituted 10.8% and 4.3% respectively.
Neurosurgeons, psychiatrists, and addiction consultant constituted 33.8% of the
prescribers of antidepressants. All other medical specialties constituted 43.5%. Friends,
family, pharmacists and self constituted 22.8% of the purchasers.
The most common reasons for taking antidepressants as mentioned by the purchasers
were anxiety and irritability which were reported by 74.4% of the purchasers. Less than
two thirds of those taking antidepressants (61.9%) experienced side effects.
The majority of the purchasers (89.2%) had a past history of psychiatric conditions, and
more than three quarters (76.9%) of them had a past history of co-morbid chronic
diseases.
There was a significant association between the use of antidepressants in the last three
months and some socio-demographic factors (sex, occupation, and marital status).
However, the association between the use of antidepressants and age, education level,
and residence was not statistically significant.
There was a statistically significant association between the use of antidepressants and
some psychiatric conditions namely obsessive compulsive, postoperative psychic
problems, and convulsions.
There was a statistically significant association between antidepressants use and comorbid
diseases namely tumors, skin diseases, obesity, stroke, orthopedic diseases,
gynecological diseases, and general weakness.
The following are the main conclusions from the study:
1. The use of antidepressants was more common among purchasers, aged 35 to less than
45 years old, males, married, those having university and postgraduate education, nonprofessionals,
and among those living in urban areas.
2. selective serotonin reuptake inhibitors were the most commonly used type of antidepressants
followed by TCAs, atypical antidepressants, herbal antidepressants and
finally SNRIs.
3. Antidepressants were mostly prescribed by neurosurgeons, psychiatrists, and all other
medical specialties, while they were sometimes recommended by friends, family,
pharmacists and self.
4. Having anxiety and irritability, and sleep disorders were the most common reasons for
the use of antidepressants.
5. There was a significant association between the use of antidepressants and sex,
occupation, and marital status of the purchasers.
6. A significant association was found between the use of antidepressants and some
psychiatric conditions like obsessive compulsive neurosis, postoperative psychic
problems, and convulsions.
7. There was a significant association between the use of antidepressants and some comorbid
diseases such as tumors, skin diseases, stroke, obesity, orthopedic diseases,
gynecological diseases, and general weakness.
The following are the main recommendations of the study:
Based on the results of the study, the following are the most important
recommendations:
I- Recommendations to the Ministry of Health and Population:
Provision of continuous education to physicians and practicing pharmacists about the
rational use of antidepressants, adverse effects and possible drug-drug interactions
with antidepressants.
Communicating the effects of irrational use of antidepressants to prescribers of these
drugs through training courses and workshops.
Promotion the use of guidelines for antidepressants use.
II- Recommendations to the physicians:
Physicians should be educated about the importance of following international
guidelines for use of antidepressants. This will help to avoid the irrational use of
antidepressants and hence avoid their adverse effects.
III- Recommendations to the pharmacists:
Pharmacists should spend more time with antidepressants purchasers explaining the
rational use, adverse effects, and drug-drug interactions.
Pharmacists should not dispense antidepressants except with prescription.
IV- Recommendations to the public:
Public health education about the rational use of antidepressants using the media and
other educational materials like posters, flyers and pamphlets.
V- Recommendations to the researchers:
A wider multistage cluster study including larger sample and various strategies might
provide more powerful results.