ArticleJournal of affective disorders2022
Do clinicians follow heuristics in prescribing antidepressants?
Article in Journal of affective disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Real-World Antidepressant Prescribing Patterns and Comparative Safety Outcomes of Commonly Prescribed Antidepressants in Patients with Depressive Disorder: A Multicenter OMOP-CDM Study.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Bridging clinical needs and economic barriers: a national survey of antidepressant prescribing across 25 hospitals in Thailand.International journal of mental health systems · 2026Article
- Association between prescriber practices and major depression treatment outcomes.Journal of mood and anxiety disorders · 2024Article
- Preferential Mixture-of-Experts: Interpretable Models that Rely on Human Expertise As Much As Possible.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational ScienceArticle
- Prescribing Medications for Alcohol Use Disorder: A Qualitative Study of Primary Care Physician Decision Making.Annals of family medicineArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundWhile clinicians commonly learn heuristics to guide antidepressant treatment selection, surveys suggest real-world prescribing practices vary widely. We aimed to determine the extent to which antidepressant prescriptions were consistent with commonly-advocated heuristics for treatment selection.
methodsThis retrospective longitudinal cohort study examined electronic health records from psychiatry and non-psychiatry practice networks affiliated with two large academic medical centers between March 2008 and December 2017. Patients included 45,955 individuals with a major depressive disorder or depressive disorder not otherwise specified diagnosis who were prescribed at least one of 11 common antidepressant medications. Specific clinical features that may impact prescribing choices were extracted from coded data, and analyzed for association with index prescription in logistic regression models adjusted for sociodemographic variables and provider type.
resultsMultiple clinical features yielded 10% or greater change in odds of prescribing, including overweight and underweight status and sexual dysfunction. These heuristics were generally applied similarly across hospital systems and psychiatrist and non-psychiatrist providers. LIMITATIONS: These analyses rely on coded clinical data, which is likely to substantially underestimate prevalence of particular clinical features. Additionally, numerous other features that may impact prescribing choices are not able to be modeled.
conclusionOur results confirm the hypothesis that clinicians apply heuristics on the basis of clinical features to guide antidepressant prescribing, although the magnitude of these effects is modest, suggesting other patient- or clinician-level factors have larger effects.
fundingThis work was funded by NSF GRFP (grant no. DGE1745303), Harvard SEAS, the Center for Research on Computation and Society at Harvard, the Harvard Data Science Initiative, and a grant from the National Institute of Mental Health (grant no. 1R01MH106577).
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