Background: This non-systematic narrative review aims to summarize the results of clinical studies evaluating the effectiveness of antidepressants used to treat mental illnesses including major depressive disorder, obsessive-compulsive disorder, somatization disorder, and anxiety disorders in Turkey. Conclusions drawn from this article can guide ongoing efforts by Turkish health policymakers to improve public health development in the country by further regulating the prescription of antidepressants.
Methods: Relevant articles regarding the effectiveness of antidepressant use were collected in June 2021 using Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus and Academic Search Complete online databases. The collected articles were then appraised using the Critical Appraisal Skills Programme to determine the reliability and quality of each article and to assess the risk of bias in each article. The summary of key findings/evidence, Critical Appraisal Skills Programme appraisal summary results, funding, study designs applied, settings covered, period covered (years), and additional comments were extracted from each article for analysis. The inclusion criteria involved articles that recounted adverse effects and effectiveness of antidepressant use in Turkey to treat mental illnesses, including anxiety disorders, major depressive disorder, somatization disorder, and obsessive-compulsive disorder. The exclusion criteria consisted of articles that included participants who resided outside of the geographic region of Turkey, abstracts, the pharmacology of antidepressant use, antidepressant off-label use, and alternative treatments.
Results: A total of 15 articles out of the 104 derived from the databases were included in the study that fell into 1 of the following main themes, “adverse effects” and “mixed results,” which accounted for 53% (8 articles) and 40% (6 articles), respectively. One outlying article was identified (7%).
Conclusions: Totally 8 out of 15 articles that recounted antidepressants prescribed for mental illnesses produced adverse effects without treatment success and 6 out of 15 articles recounted adverse effects with treatment success. One outlying article found a confound that precluded determining whether an adverse effect was caused by antidepressant use or confounded by pre-existing conditions. Given that 14 out of 15 articles recounted adverse effects associated with antidepressant use and 6 out of 15 articles recounted antidepressant treatment success, Turkish policymakers are encouraged to adopt a restrictive drug policy strategy. To sum up, antidepressant prescription and consumption should be conducted with caution to limit unnecessary risk of exposure to adverse effects associated with antidepressant use. Limitations in the research included using a non-systematic tool instead of conducting a systematic review, a limited number of articles (15 out of 104), and risk of bias was detected from appraising the articles via Critical Appraisal Skills Programme.
Cite this article as: Bahar Root S, Clarey E. Regulation of antidepressant prescription for the effective treatment of mental disorders in Turkey: A narrative review. Psychiatry Clin Psychopharmacol. 2022;32(3):250-261.