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Pharmacy Clinical Policy Bulletins
Aetna Non-Medicare Prescription Drug Plan
Subject: Antidepressants

Status Drug PR PR-QL PR-AL ST M EX‡
Selective Serotonin Reuptake Inhibitors (SSRIs)
P citalopram   X      
P fluoxetine   X      
P fluvoxamine   X      
P paroxetine   X      
P sertraline   X      
NP Sarafem®  (fluoxetine)   X      
FE Celexa®  (citalopram)   X   X X
FE Lexapro®  (escitalopram)   X   X X
FE Paxil CR®  (paroxetine SR)       X X
FE Paxil®  (paroxetine)   X   X X
FE Pexeva®  (paroxetine)   X   X X
FE Prozac®  (fluoxetine)   X   X X
FE Prozac® Weekly  (fluoxetine)   X   X X
FE Rapiflux®  (fluoxetine)   X   X X
FE Zoloft®  (sertraline)   X   X X
Selective Norepinephrine Reuptake Inhibitors (SNRIs)
P venlafaxine   X      
P Cymbalta®  (duloxetine)   X   X X
P Effexor XR®  (velafaxine SR)   X   X X
FE Effexor®  (venlafaxine)   X   X X
Tricyclic Antidepressants
P amitriptyline          
P amoxapine          
P clomipramine          
P desipramine          
P doxepin          
P imipramine          
P nortriptyline          
P protriptyline          
NP Anafranil®  (clomipramine)          
NP Asendin®  (amoxapine)          
NP Aventil®  (nortriptyline)          
NP Elavil®  (amitriptyline)          
NP Norpramine®  (desipramine)          
NP Pamelor®  (nortriptyline)          
NP Sinequan®  (doxepin)          
NP Surmontil®  (trimipramine)          
NP Tofranil®  (imipramine)          
NP Vivactil®  (protriptyline)          
Tetracyclic Antidepressants
P maprotiline   X      
P mirtazapine          
NP Ludiomil®  (maprotiline)          
NP Remeron® / Solutab  (mirtazapine)       X X
Miscellaneous Antidepressants
P budeprion   X      
P bupropion, bupropion SR   X      
P buproprion, budeprion XL   X      
P trazodone          
P Wellbutrin XL®  (bupropion SR)   X   X X
NP Desyrel®  (trazodone)       X X
FE nefazodone       X X
FE Emsam®  (selegiline td patch 24-hr)         X
FE Serzone®  (nefazodone)       X X
FE Trazamine Pak  (trazodone tab/nutritional supp cap pack)         X
FE Wellbutrin®  (bupropion)   X   X X
FE Wellbutrin SR®  (bupropion SR)   X   X X
Monoamine Oxidase Inhibitors
P tranylcypromine          
NP Marplan®  (isocarboxazid)          
NP Nardil®  (phenelzine)          
NP Parnate®  (tranylcypromine)          


Policy:

  1. Precertification Criteria

    2. Under some plans, including plans that use an open or closed formulary, certain antidepressants are subject to precertification as specifically described below.  

    A. Bupropion, bupropion SR, budeprion XL citalopram, fluoxetine, fluvoxamine, maprotiline, paroxetine, sertraline, venlafaxine, Celexa, Cymbalta, Effexor, Lexapro, Paxil, Pexeva, Prozac, Prozac Weekly, Rapiflux, Wellbutrin, Wellbutrin SR and Zoloft may be subject to quantity limits.

    According to the manufacturers, these antidepressants can be dosed up to a maximum daily dose at the interval(s) as indicated in the table below.  A quantity of each drug will be considered medically necessary as indicated in the table below; 

    Drug Maximum Daily Dose/ Dosing Interval Dosage Strength Quantity Limits
    bupropion Wellbutrin 450 mg/ Three times daily 75 mg, 100 mg Up to 180 tablets in 30 days
    bupropion SR Wellbutrin SR budeprion 400 mg/ Once or twice daily 100, 150, 200 mg Up to 60 tablets in 30 days
    bupropion XL Wellbutrin XL 450 mg/ Once daily 150 mg Up to 30 tablets in 30 days
    budeprion bupropion XL Wellbutrin XL 450 mg/ Once daily 300 mg Up to 30 tablets in 30 days
    citalopram Celexa 40 mg/ Once daily 10, 20, 40 mg Up to 30 tablets in 30 days
    Cymbalta 60 mg/ Once or twice daily 20, 30 mg Up to 60 capsules in 30 days
    Cymbalta 60 mg/ Once daily 60 mg Up to 30 capsules in 30 days
    venlafaxine Effexor 375 mg/ Two or three times daily 25, 100 mg Up to 90 tablets in 30 days
    venlafaxine Effexor 375 mg/ Two or three times daily 37.5 mg Up to 120 tablets in 30 days
    venlafaxine Effexor 375 mg/ Two or three times daily 50 mg Up to 180 tablets in 30 days
    venlafaxine Effexor 375 mg/ Two or three times daily 75 mg Up to 150 tablets in 30 days
    Effexor XR 375 mg/ Once daily 37.5, 75 mg Up to 30 capsules in 30 days
    Effexor XR 375 mg/ Twice daily 150 mg Up to 60 capsules in 30 days
    fluoxetine Prozac 80 mg/ Once or twice daily 10 mg Up to 30 tablets or capsules in 30 days
    fluoxetine Prozac 80 mg/ Once or twice daily 40 mg Up to 60 capsules in 30 days
    fluoxetine Prozac Rapiflux 80 mg/ Once or twice daily 20 mg capsules/tablets Up to 120 in 30 days
    fluoxetine Prozac 80 mg/ Once or twice daily Liquid 20 mg/5 ml Up to 300 ml in 30 days (10 ml/day)
    Prozac Weekly 90 mg/ One WEEKLY 90 mg Up to 4 capsules in 28 days
    fluvoxamine 300 mg/ Once or twice daily 25, 50 mg Up to 30 tablets in 30 days
    fluvoxamine 300 mg/ Once or twice daily 100 mg Up to 90 days in 30 days
    Lexapro 20 mg/ Once daily 5, 10, 20 mg Up to 30 tablets in 30 days
    Lexapro 20 mg/ Once daily Solution 5 mg/5 ml Up to 600 ml in 30 days
    maprotiline 225 mg/ Once daily, or can be divided 25 mg Up to 30 tablets in 30 days
    maprotiline 225 mg/ Once daily, or can be divided 50 mg Up to 60 tablets in 30 days
    maprotiline 225 mg/ Once daily, or can be divided 75 mg Up to 90 tablets in 30 days
    paroxetine Paxil, Pexeva 60 mg/ Once daily 10, 20 mg Up to 30 tablets in 30 days
    paroxetine Paxil, Pexeva 60 mg/ Once daily 30, 40 mg Up to 60 tablets in 30 days
    paroxetine Paxil, Pexeva 60 mg/ Once daily Suspension 10 mg/5 ml Up to 900 ml in 30 days
    fluoxetine Sarafem 80 mg/ Once daily 10 mg Up to 30 capsules in 30 days
    fluoxetine Sarafem 80 mg/ Once daily 20 mg Up to 120 capsules in 30 days
    sertraline Zoloft 200 mg/ Once daily 25 mg Up to 30 tablets in 30 days
    sertraline Zoloft 200 mg/ Once daily 50 mg Up to 45 tablets in 30 days
    sertraline Zoloft 200 mg/ Once daily 100 mg Up to 60 tablets in 30 days
    sertraline Zoloft 200 mg/ Once daily Liquid 20mg/ml Up to 300 ml in 30 days


    For coverage of additional quantities, a member's treating physician must request prior authorization through the Pharmacy Management Precertification Unit. A prior authorization will be granted for coverage of additional quantities of these antidepressants for those members who meet ANY of the following criteria:

    • Member requires a dose including half tablets OR
    • Member's dose is being titrated by physician (3-month limit) OR
    • Member has had intolerance to drug administered as a single daily dose OR
    • Member's dose cannot be achieved with proposed qty limits for a given strength  (ex. Mm needs 375mg per day and would require 5 capsules of Effexor XR 75mg to achieve dose ) OR
    • Member has a diagnosis of Diabetic Peripheral Neuropathy -For Cymbalta (60mg; 60 capsules in 30 days are allowed)
    • Member's physician provides documentation (controlled clinical trial) from the peer-reviewed medical literature for use of a higher dose.


  2. Step Therapy Criteria

    3. Under some plans, including plans that use an open or closed formulary, Celexa, Cymbalta, Desyrel, Effexor, Effexor XR, Lexapro, nefazodone, Paxil, Paxil CR, Pexeva, Prozac, Prozac Weekly, Rapiflux, Remeron, Remeron Solutab, Serzone, Wellbutrin, Wellbutrin SR, Wellbutrin XL and Zoloft are subject to step-therapy.  Aetna considers these drugs to be medically necessary for those members who meet the following step-therapy criterion:

    For Celexa, Cymbalta, Desyrel, Effexor, Effexor XR, Lexapro, nefazodone, Paxil, Paxil CR, Pexeva, Prozac, Prozac Weekly, Rapiflux, Remeron, Remeron Solutab, Serzone, Wellbutrin, Wellbutrin SR, Wellbutrin XL:

    A documented trial of one month of one of budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine, sertraline, trazodone or venlafaxine -alternatives on the Preferred Drug List.

    For Zoloft
    A documented trial of one month of the preferred generic equivalent sertraline.


    If it is medically necessary for a member to be treated initially with a medication subject to step-therapy, the member's treating physician may contact the Aetna Pharmacy Management Precertification Unit to request coverage as a medical exception at 1-800-414-2386. (See criteria under section III below).

  3. Medical Exception Criteria

    4. Cymbalta, Desyrel, Effexor XR, Remeron, Remeron Solutab and Wellbutrin XL are currently listed on the Aetna Step-Therapy List.* If it is medically necessary for a member to be treated initially with one of these medications subject to step-therapy, Aetna considers these drugs to be medically necessary for those members who meet the criteria specified below.  

    Celexa,  Effexor, Lexapro, nefazodone, Paxil, Paxil CR, Pexeva, Prozac, Prozac Weekly, Rapiflux, Serzone, Wellbutrin, Wellbutrin SR and Zoloft are currently listed on the Aetna Formulary Exclusions and Step-Therapy lists.* Therefore, they are excluded from coverage for members enrolled in prescription drug benefit plans that use a closed formulary or that require step-therapy criteria, unless a medical exception is granted.  Aetna considers these drugs to be medically necessary for those members who meet the criteria specified below:

    Emsam,  and Trazamine Pak are currently listed on the Aetna Formulary Exclusions list.* Therefore, they are excluded from coverage for members enrolled in prescription drug benefit plans that use a closed formulary, unless a medical exception is granted.  Aetna considers  Emsam,  and Trazamine Pak to be medically necessary for those members who meet the criteria specified below:


    For Celexa, Desyrel, Effexor, Emsam, nefazodone, Paxil, Pexeva, Prozac, Prozac Weekly, Rapiflux, Remeron, Remeron Solutab, Serzone, Wellbutrin and Wellbutrin SR:
    A.  A documented:

    • Intolerance to one generic preferred alternative - budeprion,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR
    • Contraindication to one generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Allergy to one generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Failure of an adequate trial of one month of one generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine.

    For Lexapro, Paxil CR,  Wellbutrin XL- A OR B

      A. A documented:

    • Intolerance to one generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Contraindication to one generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Allergy to one generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Failure of an adequate trial of one month of one generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine.

    OR

    B.    Member is documented to be currently stabilized on one of these antidepressants: 
            Lexapro, Paxil CR, Wellbutrin XL.

    OR

    For Cymbalta, Effexor XR    (A OR B )


    A. A documented:

    • Intolerance to one generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Contraindication to one generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Allergy to one generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Failure of an adequate trial of one month of one generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine OR 
    • Member has a documented diagnosis of Diabetic Peripheral Neuropathy. (Cymbalta- only )

    OR
    B. Member is documented to be currently stabilized on one of these antidepressants: Cymbalta or Effexor XR.

    For Zoloft


    A. A documented:

    • Intolerance to the preferred generic equivalent sertraline OR 
    • Contraindication to the preferred generic equivalent sertraline OR 
    • Allergy to the preferred generic equivalent sertraline OR 
    • Failure of an adequate trial of one month of the preferred generic equivalent sertraline

    For Trazamine Pak

    A. A documented:

    • Intolerance to two generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be trazodone)OR
    • Contraindication to two generic preferred alternatives - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be trazodone)OR
    • Allergy to two generic preferred alternatives - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be trazodone) OR
    • Failure of an adequate trial of one month of two generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be trazodone).

     For Appbutamone, Appbutamone-D

    A. A documented:

    • Intolerance to two generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be bupropion)OR 
    • Contraindication to two generic preferred alternatives - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be buproprion)OR
    • Allergy to two generic preferred alternatives - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be buproprion) OR
    • Failure of an adequate trial of one month of two generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be buproprion).

    For Gaboxetine, Sentroxatine

    A. A documented:

    • Intolerance to two generic preferred alternative - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be fluoxetine)OR
    • Contraindication to two generic preferred alternatives - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be fluoxetine)OR
    • Allergy to two generic preferred alternatives - budeprion ,bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be fluoxetine) OR
    • Failure of an adequate trial of one month of two generic preferred alternative - budeprion, bupropion, bupropion SR, citalopram, fluoxetine, fluvoxamine, paroxetine, mirtazapine sertraline  trazodone, or venlafaxine (one of which should be fluoxetine).

Place of Service:

Outpatient

The above policy is based on the following references:
  1. Hirschfeld R. Long-term side effects of SSRIs: Sexual dysfunction and weight gain. J Clin Psychiatry 2003;64 (suppl 18):20-4.
  2. Alvarez Jr W and Pickworth KK. Safety of antidepressant drugs in the patient with cardiac disease: A review of the literature. Pharmacotherapy. 2003;23(6):754-71.
  3. Golden RN, Nemeroff CB, McSorley P, et al. Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression. J Clin Psychiatry 2002;63:57-84.
  4. US Food and Drug Administration. Antidepressant use in children, adolescents, and adults. Issued March 23, 2004. Available at: http://www.fda.gov/cder/drug/antidepressants/default.htm. Accessed 4/7/2004.
  5. Clayton AH, Pradko JF, Croft HA, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002;63:357-66.
  6. Gregorian Jr RS, Golden KA, Bahce A, et al. Antidepressant-induced sexual dysfunction. Ann Pharmacother. 2002;36:1577-89.
  7. Lam RW, Wan DDC, Cohen NL, and Kennedy SH. Combining antidepressants for treatment-resistant depression: A review. J Clin Psychiatry. 2002;63:685-93.
  8. Hirschfeld RMA, Montgomery SA, Aguglia E, et al. Partial response and nonresponse to antidepressant therapy: Current approaches and treatment options. J Clin Psychiatry. 2002;63:826-37.
  9. Glassman AH, O’Connor CM, Califf RM, et al. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA. 2002;288:701-9.
  10. Labbate LA, Croft HA, and Oleshansky MA. Antidepressant-related erectile dysfunction: Management via avoidance, switching antidepressants, antidotes, and adaptation. J Clin Psychiatry. 2003;64(suppl 10):11-19.
  11. van den Brink RHS, van Melle JP, Honig A, et al. Treatment of depression after myocardial infarction and the effects on cardiac prognosis and quality of life: Rationale and outline of the Myocardial Infarction and Depression-Intervention Trial (MIND-IT). Am Heart J. 2002;144:219-25.
  12. Kornstein SG. Chronic depression in women. J Clin Psychiatry. 2002;63:602-9.
  13. Brent DA and Birmaher B. Adolescent depression. N Engl J Med. 2002;347:667-71.
  14. Rush AJ, Trivedi M, Fava M. Depression, IV: STAR*D treatment trial for depression. Am J Psychiatry. 2003;160:237.
  15. Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry. 1998;37(10 Suppl):63S-83S
  16. Rosen RC and Humberto M. Prevalence of antidepressant-associated erectile dysfunction. J Clin Psychiatry. 2003;64(suppl 10):5-10.
  17. Rapaport MH, Schneider LS, Dunner DL, et al. Efficacy of controlled-release paroxetine in the treatment of late-life depression. J Clin Psychiatry. 2003;64:1065-74.
  18. Wagner KD, Ambrosini P, Rynn M, et al. Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder. Two randomized controlled trials. JAMA. 2003;290:1033-41.
  19. MacGillivray S, Arroll B, Hatcher S, et al. Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and meta-analysis. BMJ. 2003;326:1014-7
  20. Emslie GJ, Heiligenstein JH, Wagner KD, et al. Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial. J Am Acad Child Adolesc Psychiatry. 2002;41:1205-15.
  21. Souery D, Amsterdam J, de Montigny C, et al. Treatment resistant depression: methodological overview and operation criteria. Eur Neuropsychopharmacol 1999;9:83-91.
  22. Noble S and Benfield P. Citalopram. A review of its pharmacology, clinical efficacy and tolerability in the treatment of depression. CNS Drugs. 1997;8(5):410-31.
  23. Trivedi M, Kleiber B. Algorithm for the treatment of chronic depression. J Clin Psychiatry 2001;62(Suppl 6):22-9.
  24. Richelson E. Interactions of antidepressants with neurotransmitter transporters and receptors and their clinical relevance. J Clin Psychiatry. 2003;64(suppl 13):5-12.
  25. Sproule BA, Naranjo CA, Bremner KE, Hassan PC.  Selective serotonin reuptake inhibitors and CNS drug interactions.  Clin Pharmacokinet. 1997;33:454-71.
  26. Thase ME. Achieving remission and managing relapse in depression. J Clin Psychiatry 2003;64(suppl 18):3-7.
  27. Greenblatt DJ, von Moltke LL, Harmatz JS, Shader RI. Drug interactions with newer antidepressants: Role of human cytochromes P450. J Clin Psychiatry 1998:59(S 15)19-27.
  28. Segraves RT. Antidepressant-induced sexual dysfunction. J Clin Psychiatry 1998;59(Suppl 4):48-54.
  29. Masand PS and Gupta S. Selective serotonin-reuptake inhibitors: an update. Harvard Rev Psychiatry. 1999;7:69-84.
  30. Hirschfeld RMA. Long-term side effects of SSRIs: Sexual dysfunction and weight gain. J Clin Psychiatry. 2003;64(suppl 18):20-4.
  31. Modell JG, Katholi CR, Modell JD, DePalma RL. Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline. Clin Pharmacol Ther. 1997;61:476-487.
  32. Hirschfeld RM Management of sexual side effects of antidepressant therapy. J Clin Psychiatry. 1999;60 Suppl 14:27-30; discussion 31-5
  33. Mulrow CD, Williams JW Jr, Trivedi M, chiquette E, Aquilar C, Cornell JE. Treatment of depression: Newer Pharmacotherapies. Evidence Report/Technology Assessment No. 7. Rockville, MD: Agency for Health Care Policy and Research; February 1999. AHCPR Publication No. 99-E014. www.ahcpr.gov/clin/depresumm.htm.
  34. Snow V, Lascher S, Mottur-Pilson. Clinical Guideline, Part 2. Pharmacologic treatment of acute major depression and dysthymia. Ann Intern Med. 2000;132:738-42.
  35. Williams JW, Mulrow CD, Chiquette E, et al. Clinical Guideline, Part 1. A systematic review of newer pharmacotherapies for depression in adults: Evidence report summary. Ann Intern Med 2000;132:743-56.
  36. Whooley MA and Simon GE. Managing depression in medical outpatients. New Eng J Med 2000;343:1942-50.
  37. Glick ID, Suppes T, DeBattista C, Hu RJ, and Marder S. Psychopharmacologic treatment strategies for depression, bipolar disorder, and schizophrenia. Ann Intern Med. 2001;134:47-60
  38. Fava M. Management of nonresponse and intolerance: switching strategies. J Clin Psychiatry 2000;61(suppl 2):10-2.
  39. Zajecka JM. Clinical issues in long-term treatment with antidepressants. J Clin Psychiatry 2000;61 (suppl 2):20-5.
  40. Sarko J. Antidepressants, old and new. A review of their adverse effects and toxicity in overdose. Emerg Med Clin North Am 2000;18(4);637-54.
  41. Keller MB, Ryan ND, Strober M, et al. Efficacy of paroxetine in the treatment of adolescent major depression: A randomized, controlled trial. J Am Acad Child Adolesc 2001;40:762-72.
  42. Nieuwstraten C and Dolovich LR. Bupropion versus selective serotonin-reuptake inhibitors for treatment of depression. Ann Pharmacother 2001;35:1608-13.
  43. Alexopoulos GS, Katz IR, Reynolds III CF, et al. The Expert Consensus Guideline Series. Pharmacotherapy of depressive disorders in older patients. Postgrad Med Special Report. 2001 Oct:1-88.
  44. DeVane CL. Immediate-release versus controlled-release formulations: Pharmacokinetics of newer antidepressants in relation to nausea. J Clin Psychiatry. 2003;64(suppl 18):14-19.
  45. Nemeroff CB. Improving antidepressant adherence. J Clin Psychiatry. 2003;64(suppl 18):25-30.
  46. Nierenberg AA, Petersen TJ, and Alpert JE. Prevention of relapse and recurrence in depression: The role of long-term pharmacotherapy and psychotherapy. J Clin Psychiatry. 2003;64(suppl 15):15-7.
  47. Zajecka JM. Treating depression to remission. J Clin Psychiatry. 2003;64(suppl 15):7-12.
  48. Olin BR, editor. Drugs Facts and Comparisons (electronic online version). St. Louis: J.B. Lippincott Company, 2006.
  49. USPDI Drug Information for the HealthCare Professional (online through Stat!Ref). Thomson MICROMEDEX, Greenwood Village, Colorado; 2006.
  50. McEvoy GK, editor. AHFS Drug Information (online through Stat!Ref). American Society of Health-Systems Pharmacists, Bethesda, Maryland; 2006.
  51. Medical Economics, Inc., PDR Electronic Library. Thomson Medical Economics, Montvale, NJ; 2003.
  52. Emslie GJ, Rush AJ, Weinberg WE, et al.  A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression.  Arch Gen Psychiatry. 1997;54:1031-37.
  53. Emslie GJ, Heiligenstein JH, Wagner KD, et al.  Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial.  J Am Acad Child Adolesc Psychiatry. 2002;41:1205-15.
  54. Keller MB, Ryan ND, Strober M, et al.  Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial.  J Am Acad Child Adolesc Pschiatry. 2001;40:762-72.
  55. US Food and Drug Administration.  FDA statement regarding the antidepressant Paxil for pediatric population.  FDA Talk Paper 2003;T03-T43.  Available at: http://www.fda.gov/bbs/topics/ANSWERS/2003/ANS01230.html.
  56. Wagner KD, Ambrosinin P, Rynn M, et al.  Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder: two randomized controlled trials.  JAMA. 2003;290:1033-41.
  57. Whittington CJ, Kendall T, Fonagy P, et al.  Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data.  Lancet. 2004;363:1341-1345.
  58. Briggs GG, Freeman RK, Yaffe SJ.  (2005). Drugs in pregnancy and lactation. (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
  59. GlaxoSmithKline.  2005. Important Information for Prescribers about Paroxetine and Pregnancy.  Available at: http://www.gsk.com/media/paroxetine/paroxetine_pregnancy.pdf.
  60. Nonacs R, Cohen LS.  Assessment and treatment of depression during pregnancy: An update. Psychiatr Clin North Am. 2003;26:547-62.
  61. Moses-Kolko EL, Bogen D, Perel J, et al.  Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA. 2005;293(19):2372-83.
  62. Einarson A, Bonari L, Voyer-Lavigne S, et al.  A multicenter prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy.  Can J Psychiatry. 2003;48:106-10.
  63. Standards of Medical Care in Diabetes (Position Statement) Diabetes Care, 30(Supplement-1) January 2007
  64. Appbutamone and Appbutamone-D internet product information accessed at http://ptlcopack.com/menu.htm
  65. Gaboxetine , Sentroxatine internet product information accessed at http://ptlcopack.com/menu.htm

 

Copyright Aetna Inc. All rights reserved. Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change.

June 29, 2007
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