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European Journal of Clinical Pharmacology

, Volume 71, Issue 3, pp 369–375 | Cite as

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

  • Raymond Noordam
  • Nikkie Aarts
  • Katia M. Verhamme
  • Miriam C. M. Sturkenboom
  • Bruno H. Stricker
  • Loes E. Visser
Pharmacoepidemiology and Prescription

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.

Keywords

Antidepressive agents Population surveillance Prevalence Incidence 

Notes

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.

Supplementary material

228_2014_1803_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 16 kb)

References

  1. 1.
    Hemels ME, Koren G, Einarson TR (2002) Increased use of antidepressants in Canada: 1981-2000. Ann Pharmacother 36(9):1375–1379CrossRefPubMedGoogle Scholar
  2. 2.
    Meijer WE, Heerdink ER, Leufkens HG, Herings RM, Egberts AC, Nolen WA (2004) Incidence and determinants of long-term use of antidepressants. Eur J Clin Pharmacol 60(1):57–61CrossRefPubMedGoogle Scholar
  3. 3.
    Moore M, Yuen HM, Dunn N, Mullee MA, Maskell J, Kendrick T (2009) Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database. BMJ 339:b3999CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Raymond CB, Morgan SG, Caetano PA (2007) Antidepressant utilization in British Columbia from 1996 to 2004: increasing prevalence but not incidence. Psychiatr Serv 58(1):79–84CrossRefPubMedGoogle Scholar
  5. 5.
    Sonnenberg CM, Deeg DJ, Comijs HC, van Tilburg W, Beekman AT (2008) Trends in antidepressant use in the older population: results from the LASA-study over a period of 10 years. J Affect Disord 111(2–3):299–305CrossRefPubMedGoogle Scholar
  6. 6.
    Mojtabai R, Olfson M (2011) Proportion of antidepressants prescribed without a psychiatric diagnosis is growing. Health Aff (Millwood) 30(8):1434–1442CrossRefGoogle Scholar
  7. 7.
    Olfson M, Marcus SC, Pincus HA, Zito JM, Thompson JW, Zarin DA (1998) Antidepressant prescribing practices of outpatient psychiatrists. Arch Gen Psychiatry 55(4):310–316CrossRefPubMedGoogle Scholar
  8. 8.
    Parabiaghi A, Franchi C, Tettamanti M, Barbato A, D'Avanzo B, Fortino I, Bortolotti A, Merlino L, Nobili A (2011) Antidepressants utilization among elderly in Lombardy from 2000 to 2007: dispensing trends and appropriateness. Eur J Clin Pharmacol 67(10):1077–1083CrossRefPubMedGoogle Scholar
  9. 9.
    van Eijk ME, Bahri P, Dekker G, Herings RM, Porsius A, Avorn J, de Boer A (2000) Use of prevalence and incidence measures to describe age-related prescribing of antidepressants with and without anticholinergic effects. J Clin Epidemiol 53(6):645–651CrossRefPubMedGoogle Scholar
  10. 10.
    Chemali Z, Chahine LM, Fricchione G (2009) The use of selective serotonin reuptake inhibitors in elderly patients. Harv Rev Psychiatr 17(4):242–253CrossRefGoogle Scholar
  11. 11.
    Serna C, Cruz I, Galvan L, Real J, Gasco E, Soler-Gonzalez J (2010) Evolution of the prevalence and incidence of consumption of antidepressants in a Spanish region (2002-2007). Ment Health Fam Med 7(1):9–15PubMedCentralPubMedGoogle Scholar
  12. 12.
    Aarts N, Noordam R, Hofman A, Tiemeier H, Stricker BH, Visser LE (2014) Utilization patterns of antidepressants between 1991 and 2011 in a population-based cohort of middle-aged and elderly. Eur Psychiatry 29(6):365–370CrossRefPubMedGoogle Scholar
  13. 13.
    Hansen DG, Rosholm JU, Gichangi A, Vach W (2007) Increased use of antidepressants at the end of life: population-based study among people aged 65 years and above. Age Ageing 36(4):449–454CrossRefPubMedGoogle Scholar
  14. 14.
    Spence D (2013) Are antidepressants overprescribed? Yes. BMJ 346:f191CrossRefPubMedGoogle Scholar
  15. 15.
    Reid IC (2013) Are antidepressants overprescribed? No. BMJ 346:f190CrossRefPubMedGoogle Scholar
  16. 16.
    Piek E, van der Meer K, Nolen WA (2010) Guideline recommendations for long-term treatment of depression with antidepressants in primary care—a critical review. Eur J Gen Pract 16(2):106–112CrossRefPubMedGoogle Scholar
  17. 17.
    Sihvo S, Isometsa E, Kiviruusu O, Hamalainen J, Suvisaari J, Perala J, Pirkola S, Saarni S, Lonnqvist J (2008) Antidepressant utilisation patterns and determinants of short-term and non-psychiatric use in the Finnish general adult population. J Affect Disord 110(1–2):94–105CrossRefPubMedGoogle Scholar
  18. 18.
    Coupland C, Dhiman P, Morriss R, Arthur A, Barton G, Hippisley-Cox J (2011) Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ 343:d4551CrossRefPubMedCentralPubMedGoogle Scholar
  19. 19.
    Coupland CA, Dhiman P, Barton G, Morriss R, Arthur A, Sach T, Hippisley-Cox J (2011) A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database. Health Technol Assess 15(28):1–202, iii-ivCrossRefPubMedGoogle Scholar
  20. 20.
    Landelijke Stuurgroep Multidisciplinaire Richtlijnontwikkeling in de GGZ (2008) Addendum ouderen bij de MDR depressie. Versie 1.0. Trimbos Instituut, UtrechtGoogle Scholar
  21. 21.
    Abbing-Karahagopian V, Huerta C, Souverein PC, de Abajo F, Leufkens HG, Slattery J, Alvarez Y, Miret M, Gil M, Oliva B, Hesse U, Requena G, de Vries F, Rottenkolber M, Schmiedl S, Reynolds R, Schlienger RG, de Groot MC, Klungel OH, van Staa TP, van Dijk L, Egberts AC, Gardarsdottir H, De Bruin ML (2014) Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications. Eur J Clin Pharmacol 70(7):849–857CrossRefPubMedGoogle Scholar
  22. 22.
    Lamberts H, Wood M, Hofmans-Okkes IM (1992) International primary care classifications: the effect of fifteen years of evolution. Fam Pract 9(3):330–339CrossRefPubMedGoogle Scholar
  23. 23.
    van Marwijk HJW, Grundmeijer HGLM, Brueren MM, Sigling HO, Stolk J, van Gelderen MG (1994) NHG-standaard Depressie. Huisarts Wet 37:482–490Google Scholar
  24. 24.
    van Marwijk HWJ, Grundmeijer HGLM, van Gelderen MG, de Haan M, Weel-Baumgarten EM (2003) NGH-standaard Depressive stoornis (eerste herziening). Huisarts Wet 46:614–623CrossRefGoogle Scholar
  25. 25.
    Landelijke Stuurgroep Multidisciplinaire Richtlijnontwikkeling in de GGZ (2005) Richtlijnherziening van de Multidisciplinaire richtlijn Depressie (eerste revisie). Richtlijn voor de diagnostiek, behandeling en begeleding van volwassen patiënten met een depressieve stoornis. Trimbos Instituut, UtrechtGoogle Scholar
  26. 26.
    Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV, De Graaf R, Vollebergh W, Dragomirecka E, Kohn R, Keller M, Kessler RC, Kawakami N, Kilic C, Offord D, Ustun TB, Wittchen HU (2003) The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 12(1):3–21CrossRefPubMedGoogle Scholar
  27. 27.
    Blazer DG, Kessler RC, McGonagle KA, Swartz MS (1994) The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am J Psychiatry 151(7):979–986CrossRefPubMedGoogle Scholar
  28. 28.
    Biegstraaten M, van Leersum L, Van Schaik IN (2007) Medicamenteuze behandeling van perifere neuropathische pijn. Gebu 41(8):83–92Google Scholar
  29. 29.
    Verduijn MM, Folmer H (2007) Medicamenteuze pijnbestrijding. NHG - Farmacotherapeutische RichtlijnGoogle Scholar
  30. 30.
    Central Bureau of Statistics. www.cbs.nl. Accessed 6 Jan 2014
  31. 31.
    Het College voor zorgverzekeringen (2013) Aantal gebruikers 2008-2012 voor ATC-subgroep N06A: Antidepressiva. http://www.gipdatabank.nl/. Last updated 12 Nov 2013; accessed 6 Jan 2014
  32. 32.
    Gardarsdottir H, Heerdink ER, van Dijk L, Egberts AC (2007) Indications for antidepressant drug prescribing in general practice in the Netherlands. J Affect Disord 98(1–2):109–115CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Raymond Noordam
    • 1
    • 2
  • Nikkie Aarts
    • 1
    • 2
  • Katia M. Verhamme
    • 3
  • Miriam C. M. Sturkenboom
    • 3
  • Bruno H. Stricker
    • 1
    • 2
    • 4
  • Loes E. Visser
    • 1
    • 2
    • 5
  1. 1.Department of EpidemiologyErasmus MC–University Medical Center RotterdamRotterdamThe Netherlands
  2. 2.Department of Internal MedicineErasmus MC–University Medical Center RotterdamRotterdamThe Netherlands
  3. 3.Department of Medical InformaticsErasmus MC–University Medical Center RotterdamRotterdamThe Netherlands
  4. 4.Inspectorate of Health CareThe HagueThe Netherlands
  5. 5.Apotheek Haagse Ziekenhuizen–HAGAThe HagueThe Netherlands

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