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Anti-depressant Prescribing Patterns Among Prison Inmates With Depressive Disorders

NCJ Number
194054
Author(s)
Jacques Baillargeon Ph.D.; Sandra A. Black Ph.D.; Salvador Contreras M.D.; James Grady Dr.PH; John Pulvino P.A.
Date Published
1999
Length
19 pages
Annotation
Since prison inmates are reported to exhibit elevated rates of depressive disorders, this study examined anti-depressant prescribing patterns in Texas correctional institutions.
Abstract
The study sample consisted of 5,305 Texas inmates who had been diagnosed with one of three depressive disorders: major depression, dysthymia, and bipolar disorder, excluding those with manic episodes only. An institution-wide medical information system yielded information on medical conditions, sociodemographic factors, and pharmacotherapy. An analysis of these data found that over 50 percent of all the inmates diagnosed with depression disorders were treated with tricyclic anti-depressants (TCA's); approximately 31 percent were treated with selective serotonin re-uptake inhibitors (SSRI); and over 20 percent were not administered any form of anti-depressant medication. Prescribing patterns varied substantially according to a number of sociodemographic factors. Female inmates diagnosed with depressive disorders were more often administered SSRI's, but were less often administered TCA's and no treatment than their male counterparts. Hispanics had a higher prevalence of no pharmacotherapy compared with whites or Blacks, and inmates aged 50 and over with a diagnosis of major depression were less often prescribed pharmacotherapy than their younger-aged counterparts. Compared to practitioners in noncorrectional settings, the Texas prison system prescribes a substantially higher percentage of TCA's and a smaller percentage of SSRI's. Given the higher cost of SSRI's, the increased use of these new agents in correctional settings will require strong evidence that they are superior in efficacy, adherence, and cost-effectiveness. There is a current lack of such evidence. Suggestions for future research are offered regarding sociodemographic differences in prescribing patterns. 5 tables and 28 references