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European Journal of Clinical Pharmacology

, Volume 60, Issue 9, pp 629–634 | Cite as

Are we going to increase the use of antidepressants up to that of benzodiazepines?

  • Arcangelo Ciuna
  • Margherita Andretta
  • Letizia Corbari
  • Deborah Levi
  • Mersia Mirandola
  • Adriano Sorio
  • Corrado Barbui
Pharmacoepidemiology and Prescription

Abstract

Objective

The present study compared recent trends in benzodiazepine and antidepressant consumption in Italy and projected their global sales in the future. We investigated whether the increasing use of antidepressants is associated with a progressive reduction in benzodiazepine use.

Methods

Data concerning actual quantities of benzodiazepines and antidepressants dispensed in Italy from 1995 to June 2003 were obtained from IMS Health. For each agent, the number of defined daily doses (DDDs) per 1000 inhabitants per day and the annual expenditure in Euros was calculated.

Results

During the 9-year period, benzodiazepine consumption remained substantially stable, accounting for 50 DDDs/1000 per day in 2003. In the same period, antidepressant consumption dramatically rose, from 9 DDDs/1000 per day in 1995 to 26 DDDs/1000 per day in 2003, an increase of nearly three times. While the use of tricyclic antidepressants declined by one-third and that of other older agents remained substantially stable, the use of selective serotonin-reuptake inhibitors and newer agents (venlafaxine, mirtazapine, reboxetine) increased by 623%. Global consumption of antidepressants was projected to increase still further, and, in 2007, the total sales of antidepressants were projected to be similar to the total sales of benzodiazepines. The value of benzodiazepine sales increased from 322 million to 565 million Euros, an increase of 43%; similarly, the value of antidepressant sales increased from 186 million to 569 million Euros, an increase of 67%.

Conclusions

In Italy, the consumption of benzodiazepines was not affected by the increased prescribing of selective serotonin-reuptake inhibitors and newer antidepressants.

Keywords

Paroxetine Eating Disorder Venlafaxine Mirtazapine Total Sale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The authors have never received financial support from drug companies and have never done consultancy for pharmaceutical companies. This work received no funding. Arcangelo Ciuna suddenly died during the preparation of this manuscript, which is dedicated to his memory.

References

  1. 1.
    Dimmock PW, Wyatt KM, Jones PW et al (2000) Efficacy of selective serotonin-reuptake inhibitors in premenstrual syndrome: a systematic review. Lancet 356:1131–1136CrossRefPubMedGoogle Scholar
  2. 2.
    Isacsson G, Boethius G, Henriksson S et al (1999) Selective serotonin reuptake inhibitors have broadened the utilisation of antidepressant treatment in accordance with recommendations. Findings from a Swedish prescription database. J Affect Disord 53:15–22CrossRefPubMedGoogle Scholar
  3. 3.
    Lawrenson RA, Tyrer F, Newson RB et al (2000) The treatment of depression in UK general practice: selective serotonin reuptake inhibitors and tricyclic antidepressants compared. J Affect Disord 59:149–157CrossRefPubMedGoogle Scholar
  4. 4.
    Middleton N, Gunnell D, Whitley E et al (2001) Secular trends in antidepressant prescribing in the UK, 1975–1998. J Public Health Med 23:262–267CrossRefPubMedGoogle Scholar
  5. 5.
    Piccinelli M, Pini S, Bellantuono C et al (1995) Efficacy of drug treatment in obsessive-compulsive disorder: a meta-analytic review. Br J Psychiatry 166:424–452PubMedGoogle Scholar
  6. 6.
    Rosholm JU, Andersen M, Gram LF (2001) Are there differences in the use of selective serotonin reuptake inhibitors and tricyclic antidepressants? A prescription database study. Eur J Clin Pharmacol 56:923–929CrossRefPubMedGoogle Scholar
  7. 7.
    Sramek JJ, Zarotsky V, Cutler NR (2002) Generalised anxiety disorder: treatment options. Drugs 62:1635–1648PubMedGoogle Scholar
  8. 8.
    Medawar C, Herxheimer A (2003) A comparison of adverse drug reaction reports from professionals and users, relating to risk of dependence and suicidal behaviour with paroxetine. Int J Risk Saf Med 16:5–19Google Scholar
  9. 9.
    Medawar C (1997) The antidepressant web—marketing depression and making medicines work. Int J Risk Saf Med 10:75–126Google Scholar
  10. 10.
    WHO Collaborating Centre for Drug Statistic Methodology (2003) Guidelines for ATC Classification and DDD Assignment. WHO Collaborating Centre for Drug Statistic Methodology, OsloGoogle Scholar
  11. 11.
    Jones G (2003) Prescribing and taking medicines: concordance is a fine theory but it is mostly not being practised. BMJ 327: 819CrossRefPubMedGoogle Scholar
  12. 12.
    Barbui C, Broglio E, Costa Laia A, D’Agostino S, Enrico F, Ferraro L, Fiorio E, Miletti F, Pietraru C, Poggio L, Tognoni G (2003) Cross-sectional database analysis of antidepressant prescribing in Italy. J Clin Psychopharmacol 23:31–34CrossRefPubMedGoogle Scholar
  13. 13.
    Tiller JW (1994) Reducing the use of benzodiazepines in general practice. BMJ 309:3–4PubMedGoogle Scholar
  14. 14.
    Martikainer J, Paakkari P, Paldàn M, Voipo T (2002) Medicines in 2002. Laakevuosi 28:21–28 Google Scholar
  15. 15.
    Busto U, Lanctot KL, Isaac P, Adrian M (1989) Benzodiazepine use and abuse in Canada. Can Med Ass J 141:917–921Google Scholar
  16. 16.
    Mant A, Whicker SD, McManus P, Birkett DJ, Edmonds D, Dumbrell D (1993) Benzodiazepine utilisation in Australia: report from a new pharmacoepidemiological database. Aust J Public Health 17:345–349PubMedGoogle Scholar
  17. 17.
    APA (American Psychiatric Association) (1990) Benzodiazepine dependency, toxicity, and abuse. WashingtonGoogle Scholar
  18. 18.
    O’Malley PG, Jackson JL, Santoro J, Tomkins G, Balden E, Kroenke K (1999) Antidepressant therapy for unexplained symptoms and symptom syndromes. J Fam Pract 48:980–990PubMedGoogle Scholar
  19. 19.
    Dubini A, Mannheimer R, Pancheri P (2001) Depression in the community: results of the first Italian survey. Int Clin Psychopharmacol 16:49–53CrossRefPubMedGoogle Scholar
  20. 20.
    Bellantuono C, Mazzi MA, Rizzo R, Tansella M, Goldberg DP (2002) The identification of depression and the coverage of antidepressant drug prescriptions in Italian general practice. J Affect Disord 72:53–59CrossRefPubMedGoogle Scholar
  21. 21.
    Rose N (2003) Neurochemical selves. Society November/December, pp 46–59Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Arcangelo Ciuna
    • 1
    • 2
  • Margherita Andretta
    • 1
  • Letizia Corbari
    • 1
  • Deborah Levi
    • 2
  • Mersia Mirandola
    • 1
  • Adriano Sorio
    • 1
  • Corrado Barbui
    • 2
  1. 1.Servizio Farmaceutico ULSS 20VeronaItaly
  2. 2.Department of Medicine and Public Health, Section of PsychiatryUniversity of VeronaVeronaItaly

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