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Prescription and indication trends of antidepressant drugs in the Netherlands between 1996 and 2012: a dynamic population-based study

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Antidepressant drug use increases worldwide. It is pivotal to closely monitor the use of antidepressants and to determine in what subpopulations the rise is most substantial. In a Dutch primary care database, we aimed to investigate the (sex- and age-specific) prevalence and incidence of antidepressant prescription and to monitor the indication of incident prescriptions over a 17-year period (1996–2012).

Methods

This study, embedded in the Integrated Primary Care Information database, included all patients aged 10 years or older. Per calendar year, prevalence and incidence of antidepressant drug prescription were calculated by drug class (tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and others), sex, and age. The indication of incident prescriptions (e.g., depression, anxiety, sleep disorders, and neuropathic pain) was determined based on the International Classification of Primary Care codes.

Results

In total, 1.49 million patients were included. For all antidepressants together, the prevalence increased over time. However, incident prescription of specific SSRIs decreased from 2000 onward. During the study period, incidence and prevalence were higher in older and female patients. The increase in prevalence and the decrease in incidence were more pronounced in females than that in males. Furthermore, antidepressants were increasingly prescribed for indications such as neuropathic pain and sleep disorders.

Conclusions

In Dutch primary care, prevalent prescription of antidepressants continued to increase, but incident prescription of particular SSRIs decreased from 2000 onward. In later years, antidepressants were less frequently prescribed for depression-related indications in incident users.

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Acknowledgments

We would like to thank the contributing general practitioners in the IPCI project. The present study was funded by the Priority Medicines Elderly program of the Netherlands Organisation for Health Research and Development (ZonMw) (113191992 to LEV, governmental institution).

Authors contribution

Data analysis: RN, NA, and KMV. Interpretation of the data: RN, NA, KMV, BHS, and LEV. Drafting the manuscript: RN, NA, and LEV. Study design: MCMS and BHS. Commenting on initial versions of the manuscript: RN, NA, KMV, MCMS, BHS, and LEV. Final approval of the manuscript: RN, NA, KMV, MCMS, BHS, and LEV.

Conflict of interest

The authors declare to have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Erasmus MC–University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

    Raymond Noordam, Nikkie Aarts, Bruno H. Stricker & Loes E. Visser

  2. Department of Internal Medicine, Erasmus MC–University Medical Center Rotterdam, Rotterdam, The Netherlands

    Raymond Noordam, Nikkie Aarts, Bruno H. Stricker & Loes E. Visser

  3. Department of Medical Informatics, Erasmus MC–University Medical Center Rotterdam, Rotterdam, The Netherlands

    Katia M. Verhamme & Miriam C. M. Sturkenboom

  4. Inspectorate of Health Care, The Hague, The Netherlands

    Bruno H. Stricker

  5. Apotheek Haagse Ziekenhuizen–HAGA, The Hague, The Netherlands

    Loes E. Visser

Authors
  1. Raymond Noordam
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  2. Nikkie Aarts
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  3. Katia M. Verhamme
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  4. Miriam C. M. Sturkenboom
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  5. Bruno H. Stricker
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  6. Loes E. Visser
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Corresponding author

Correspondence to Bruno H. Stricker.

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Noordam, R., Aarts, N., Verhamme, K.M. et al. Prescription and indication trends of antidepressant drugs in the Netherlands between 1996 and 2012: a dynamic population-based study. Eur J Clin Pharmacol 71, 369–375 (2015). https://doi.org/10.1007/s00228-014-1803-x

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  • DOI: https://doi.org/10.1007/s00228-014-1803-x

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