OBJECTIVES: To evaluate the utilization of monotherapy second-generation antidepressants for treating depression among adults in the US based on patients’ characteristics. Also, to investigate the association between second-generation antidepressant utilization and visits to mental health professionals.

METHOD: A cross-sectional secondary data analysis using the National Health and Nutrition Examination Survey database from 2013-2018. The study participants included adults aged above 19 years, diagnosed with depression, and were taking only one of the second-generation antidepressants approved by 2013. Patients taking more than one antidepressant were excluded. Binary logistic regression was conducted using “seen mental health professional in the last 12 months?” as the dependent variable. Independent variables included medication type, age, gender, and race.

RESULTS: 969 patients were included in the study. The most utilized medication was Sertraline (19%). Overall, 70% of the participants were females. Second-generation antidepressants were highly utilized among persons aged 60 years and above (44%), compared to younger persons aged 20-39 years (20%). Non-Hispanic Whites (60%) were the most users of second-generation antidepressants. Patients on Sertraline and Paroxetine (50% and 47%, respectively) were less likely to see mental health specialist compared with patients on Fluoxetine. Females on second-generation antidepressant were 52% less likely to visit mental health professional than males. Non-Hispanic Blacks and Hispanics on second-generation antidepressants (90% and 60%, respectively) were more likely to visit a mental health professional compared with non-Hispanic Whites. Patients aged 40-59, and 60-80 years (54% and 23%, respectively) were less likely to visit mental health professional compared with younger patients.

CONCLUSION: Monotherapy second-generation antidepressants’ utilization trends varied significantly based on patients’ characteristics such as age, gender, and race. Sertraline was utilized more than other antidepressants and was associated with less utilization of mental health services, which is consistent with the clinical findings that it is well-tolerated and have better patient-reported outcomes.