Limerick East): I am aware of the article referred to by the Deputy which was merely a commentary on some studies in the United States. Other studies have shown that any savings resulting from the use of selective serotonin reuptake inhibitors — SSRIs — are offset by the higher costs of these drugs and have indicated that further studies are required before any firm conclusions can be drawn. No pharmacoeconomic analysis of SSRIs versus tricyclic antidepressants — TCAs — has been carried out in this country.
The prescribing of drugs for the treatment of depression is a matter for the individual doctor who has the duty and obligation to provide the most appropriate management for each patient. While the indicative drug target scheme offers doctors incentives to engage in cost effective prescribing, the right of the doctor to prescribe, as he-she considers necessary remains absolutely in place. In this context the targets are increased annually to take account specifically of the newer more expensive drugs, including SSRIs, coming on the market.
A recent fact sheet on prescribing for depression issued to medical practitioners by the National Medicines Information Centre indicated that while SSRIs and TCAs are equally effective in treating depression, as the side effects differ, the choice of therapy will depend on the patient's symptoms and other conditions.
