Antidepressant medication prescribing patterns in Irish general practice from 2016 to 2020 to assess for long-term use

Ir J Med Sci. 2022 Oct;191(5):2239-2246. doi: 10.1007/s11845-021-02833-7. Epub 2021 Oct 29.

Abstract

Background/aims: The aim of this study was to identify the trends in antidepressant (AD) medication use in two Irish general practices over a 5-year period, 2016 to 2020. The rationale for this study is attributed to the growing prevalence of depression amongst the Irish general public as well as concerns surrounding long-term AD medication use.

Methods: The research was undertaken in 2021 examining AD prescription rates from 2016 to 2020. The medications of interest were selective serotonin and norepinephrine reuptake inhibitors (SSRI and SNRIs): sertraline, escitalopram, fluoxetine and venlafaxine. The number of medical card holders (MCH) and prescription dispensing rates were analysed for observable trends.

Results: AD medication use is rising amongst the Irish MCH population. The number of MCH prescribed AD grew from 9.42 to 12.3 per 100 MCH between the years 2016 and 2020, respectively. The year 2020 represented the largest proportion of MCH prescriptions, 6.32 AD prescriptions per 1000 MCH prescriptions. The years 2019 to 2020 represented the largest annual increase in prescription dispensing with a growth of 0.45 per 1000 MCH prescriptions. Annual figures show a continual increase in AD dispensing refill rates from 4.14 to 5.67 per 1000 MCH prescriptions in 2016 and 2020, respectively.

Conclusion: This study illustrates a steady rise in AD medication within the general practice setting, with an observed rise in prescription dispensing rates. The high proportion of refill prescriptions demonstrates the long-term use of AD medications. This may be indicative of chronic depression or may highlight a lack of appropriate medication cessation strategies.

Keywords: Antidepressants; Depression; General practice; Long-term use; Medication; Prescribing.

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Drug Prescriptions
  • Fluoxetine
  • General Practice*
  • Humans
  • Practice Patterns, Physicians'
  • Serotonin and Noradrenaline Reuptake Inhibitors*
  • Sertraline
  • Venlafaxine Hydrochloride

Substances

  • Antidepressive Agents
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Fluoxetine
  • Venlafaxine Hydrochloride
  • Sertraline