Supplementary material BMJ Open
Supplementary File Title: A protocol for studying racial/ethnic disparities in depression care utilizing joint information from participant surveys and administrative claims databases Appendices Appendix A: ICD codes for major depressive disorders
ICD-9 ICD-10
Major depressive affective disorder, single episode, unspecified 296.20 F32.9 Major depressive affective disorder, single episode, mild 296.21 F32.0
Major depressive affective disorder, single episode, moderate 296.22 F32.1
Major depressive affective disorder, single episode, severe, without 296.23 F32.2 mention of psychotic behavior
Major depressive affective disorder, single episode, severe, 296.24 F32.3 specified as with psychotic behavior
Major depressive affective disorder, single episode, in partial or 296.25 F32.4 unspecified remission
Major depressive affective disorder, single episode, in full 296.26 F32.5 remission
Major depressive affective disorder, recurrent episode, unspecified 296.30 F33.9
Major depressive affective disorder, recurrent episode, mild 296.31 F33.0
Major depressive affective disorder, recurrent episode, moderate 296.32 F33.1
Major depressive affective disorder, recurrent episode, severe, 296.33 F33.2 without mention of psychotic behavior
Major depressive affective disorder, recurrent episode, severe, 296.34 F33.3 specified as with psychotic behavior
Major depressive affective disorder, recurrent episode, in partial or 296.35 F33.41 unspecified remission
Major depressive affective disorder, recurrent episode, in full 296.36 F33.42 remission
Other recurrent depressive disorders F33.8
Bipolar affective disorder, current episode mild or moderate 296.51 F31.31 depression
Bipolar affective disorder, current episode mild or moderate 296.52 F31.32 depression
Donneyong M, et al. BMJ Open 2020; 10:e033173. doi: 10.1136/bmjopen-2019-033173 Supplementary material BMJ Open
Bipolar affective disorder, current episode severe depression 296.53 F31.4 without psychotic symptoms
Bipolar affective disorder, current episode severe depression with 296.54 F31.5 psychotic symptoms
Bipolar affective disorder, current episode mixed 296.6
Other depressive episodes 296.82 F32.8
Unspecified mood disorder 296.90 F39
Dysthymia 300.4 F34.1
Adjustment Disorders 309.0 F43.2
Adjustment disorder with depressed mood 309.1 F43.21
Adjustment disorder with mixed anxiety and depressed mood 309.28 F43.23
Depressive disorder, not elsewhere classified 311 F32.9
Appendix B. Classification of antidepressants by therapeutic classes
Therapeutic class Drug name First-generation antidepressants Amitriptyline Amoxapine Clomipramine Desipramine Tricyclic antidepressants (TCA) Doxepin Imipramine Nortriptyline Protriptyline Trimipramine Isocarboxazid Monoamine Oxidase Inhibitors (MAOIs) Phenelzine Tranylcypromine Selegiline (MAO-B inhibitor) Tetracyclic Maprotiline Noradrenergic and specific serotonergic Mirtazapine antidepressant Blocks post-synaptic serotonin 5-HT2A receptors Nefazodone Blocks post-synaptic serotonin 5-HT2A receptors Trazodone Second-generation antidepressants Noradrenaline (norepinephrine)-dopamine reuptake Bupropion inhibitor (NDRI) Bupropion SR
Donneyong M, et al. BMJ Open 2020; 10:e033173. doi: 10.1136/bmjopen-2019-033173 Supplementary material BMJ Open
Therapeutic class Drug name Citalopram Escitalopram Fluoxetine Selective serotonin-reuptake inhibitors (SSRI) Fluvoxamine Paroxetine Sertraline
Third-generation antidepressants Noradrenaline-dopamine reuptake inhibitor Bupropion XL Selective noradrenaline reuptake inhibitors (SNRI) Duloxetine Venlafaxine Venlafaxine XR Levomilnacipran Desvenlafaxine Other antidepressants Agomelatine Ramelteon Other psychotropic medications First-generation (typical) antipsychotics Butyrophenones Droperidol Haloperidol Diphenylbutylpiperidines Pimozide Phenothiazines Chlorpromazine Fluphenazine Mesoridazine Perazine Perphenazine Prochlorperazine Promethazine Thioridazine Trifluoperazine Thioxanthenes Thiothixene Benzamides Sulpiride Tricyclics Loxapine Others Molindone Second-generation (atypical) antipsychotics Benzisoxazoles/benzisothiazoles Iloperidone Lurasidone Paliperidone Paliperidone palmitate Risperidone Ziprasidone Phenylpiperazines/quinolinones Aripiprazole Aripiprazole lauroxil Brexpiprazole Cariprazine Tricyclics Asenapine Clozapine Olanzapine
Donneyong M, et al. BMJ Open 2020; 10:e033173. doi: 10.1136/bmjopen-2019-033173 Supplementary material BMJ Open
Therapeutic class Drug name Olanzapine/fluoxetine Quetiapine Others Pimavanserin Sertindole Mood stabilizers Lithium Oxcarbazepine Carbamazepine Lamotrigine Valproate Valproic acid Gabapentin Topiramate Oxcarbazepine Tiagabine Pregabalin Stimulants Amphetamine Amphetamine/Dextroamphetamine Dextroamphetamine Methamphetamine Methylphenidate Dexmethylphenidate Lisdexamfetamine Pemoline Anti-anxiety and sedative/hypnotic agents Benzodiazepines Chlorazepate Chlordiazepoxide Diazepam Flurazepam Lorazepam Oxazepam Temazepam Clonazepam Alprazolam Estazolam Triazolam Midazolam Non-benzodiazepines Buspirone Meprobamate Carisoprodol Zopiclone Zaleplon Zolpidem Eszopiclone Suvorextant Other psychotropic Atomoxetine
Donneyong M, et al. BMJ Open 2020; 10:e033173. doi: 10.1136/bmjopen-2019-033173 Supplementary material BMJ Open
Therapeutic class Drug name Modafinil
Appendix C: Grouping of antidepressants according to treatment guidelines based on the Canadian Network for Mood and Anxiety Treatments (CANMAT)
Antidepressant (brand Mechanism Dose range names (s))
First line
Agomelatinea (Valdoxan) MT1 and MT2 agonist; 5-HT2 antagonist 25-50 mg
Bupropion (Wellbutrin)b NDRI 150-300 mg
Citalopram (Celexa, Cipramil) SSRI 20-40 mg
Desvenlafaxine (Pristiq) SNRI 50-100 mg
Duloxetine (Cymbalta) SNRI 60 mg
Escitalopram (Cipralex, SSRI 10-20 mg Lexapro)
Fluoxetine (Prozac) SSRI 20-60 mg
Fluvoxamine (Luvox) SSRI 100-300 mg
Mianserina (Tolvon) a2-Adrenergic agonist; 5-HT2 antagonist 60-120 mg SNRI
Milnaciprana (Ixel) a2-Adrenergic agonist; 5-HT2 antagonist 100 mg SSRI
Mirtazapine (Remeron) SSRI 15-45 mg
Paroxetine (Paxil) a2-Adrenergic agonist; 5-HT2 antagonist 20-50 mg SNRI
Sertraline (Zoloft) SSRI 50-200 mg
Venlafaxine (Effexor) SNRI 75-225 mg
Vortioxetine (Brintellix, Serotonin reuptake inhibitor; 5-HT1A 10-20 mg Trintellix) agonist; 5-HT1B partial agonist; 5-HT1D, 5- HT3A, and 5-HT7 antagonist
Second line
Amitriptyline (Elavil), TCA Various clomipramine (Anafranil), and others
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Levomilnacipran (Fetzima) SNRI 40-120 mg Moclobemide (Manerix) Reversible inhibitor of MAO-A 300-600 mg Quetiapine (Seroquel) Atypical antipsychotic 150-300 mg
Selegiline transdermal Irreversible MAO-B inhibitor 6-12 mg daily (Emsam) transdermal Trazodone (Desyrel) Serotonin reuptake inhibitor; 5-HT2 150-300 antagonist mg Vilazodone (Viibryd) Serotonin reuptake inhibitor; 5-HT1A partial 20-40 mg agonist (titrate from 10 mg) Third line
Phenelzine (Nardil) Irreversible MAO inhibitor 45-90 mg
Tranylcypromine (Parnate) MAO inhibitor 20-60 mg Reboxetine (Edronax) Noradrenaline reuptake inhibitor 8-10 mg
Appendix D: The Current Procedural Terminology (CPT) codes for psychotherapy CPT Description Codes
90832 Psychotherapy, 30 minutes
90833 Psychotherapy with E&M (evaluation and management), 30 minutes
90834 Psychotherapy, 45 minutes
90836 Psychotherapy with E&M, 45 minutes
90837 Psychotherapy, 60 minutes
90838 Psychotherapy with E&M, 60 minutes
4062F Patient referral for psychotherapy documented (MDD, MDD ADOL)
90846 Family psychotherapy (without the patient present), 50 minutes
90847 Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes
90849 Multiple-family group psychotherapy
90853 Group psychotherapy (other than of a multiple-family group)
90863 Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services (List separately in addition to the code for primary procedure)
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CPT Description Codes
90875 Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes
90876 Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 45 minutes
99354 Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management or psychotherapy service)
99355 Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)
G0410 Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes
G0411 Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes
Donneyong M, et al. BMJ Open 2020; 10:e033173. doi: 10.1136/bmjopen-2019-033173