Antidepressant medication use by patients accessing a national digital mental health service

Lauren G. Staples, Lia Asrianti, Eyal Karin, Rony Kayrouz, Shane Cross, Madelyne Bisby, Alana Fisher, Blake F. Dear, Nickolai Titov, Olav Nielssen

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1 Citation (Scopus)
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Background: Digital mental health services (DMHSs) provide psychological treatments via the internet or phone and are increasingly being offered as part of routine care. This study describes antidepressant (AD) medication use and treatment outcomes in a large sample of routine care patients accessing a DMHS.

Methods: Patients completing an assessment with an Australia-wide DMHS (MindSpot Clinic) from 1st January to 31st December 2020 (n = 17,409) were asked about psychotropic medication use. Demographic characteristics and treatment outcomes on the PHQ-9 (depression), GAD-7 (anxiety), and K-10+ (general distress) were compared for patients taking an AD versus no AD. Treatment outcomes were also analyzed for a subgroup of patients reporting recent commencement of AD medication.

Results: Almost one quarter of patients (4141/17409; 23.8%) reported taking an AD, mainly selective serotonin reuptake inhibitors (SSRIs). Patients taking ADs had more severe symptoms however effect sizes were large (Cohen's d's > 1.0). Patients recently commencing ADs had the highest baseline symptoms but showed greater symptom improvement at post-treatment and 3-month follow-up.

Limitations: Treatment trajectory was measured weekly using standardized scales that are sensitive to change, however they did not allow formal clinical diagnoses of depression and were subject to the effects of missing data. The observational design did not control for spontaneous recovery or for comorbid conditions that might influence recovery.

Conclusions: Despite these limitations, online treatment provided by a DMHS as part of routine care is acceptable and effective for patients reporting concurrent AD medication use.

Original languageEnglish
Pages (from-to)305-313
Number of pages9
JournalJournal of Affective Disorders
Early online date18 Apr 2022
Publication statusPublished - 1 Jul 2022

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • digital mental health
  • telehealth
  • depression
  • antidepressant medication
  • service utilization
  • service implementation


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