Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database


Moore, Michael, Yuen, Ho Ming, Dunn, Nick, Mullee, Mark A., Maskell, Joe and Kendrick, Tony (2009) Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database. British Medical Journal, 339, (b3999), 952-954. (doi:10.1136/bmj.b3999). (PMID:19833707).

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Description/Abstract

Objective: to explore the reasons behind the recent increase in antidepressant prescribing in the United Kingdom.

Design: detailed retrospective analysis of data on general practitioner consultations and antidepressant prescribing. Data source: data were obtained from the general practice research database, which contains linked anonymised records of over 3 million patients registered in the UK. Data were extracted for all new incident cases of depression between 1993 and 2005.

Review methods: detailed analysis of general practitioner consultations and antidepressant prescribing was restricted to 170 practices that were contributing data for the full duration of the study.

Results: in total, 189 851 people within the general practice research database experienced their first episode of depression between 1993 and 2005, of whom 150 825 (79.4%) received a prescription for antidepressants in the first year of diagnosis. This proportion remained stable across all the years examined. The incidence of new cases of depression rose in young women but fell slightly in other groups such that overall incidence increased then declined slightly (men: 7.83 cases per 1000 patient years in 1993 to 5.97 in 2005, women: 15.83 cases per 1000 patient years in 1993 to 10.06 in 2005). Antidepressant prescribing nearly doubled during the study period—the average number of prescriptions issued per patient increased from 2.8 in 1993 to 5.6 in 2004. The majority of antidepressant prescriptions were given as long term treatment or as intermittent treatment to patients with multiple episodes of depression.

Conclusions: the rise in antidepressant prescribing is mainly explained by small changes in the proportion of patients receiving long term treatment. Previous clinical guidelines have focused on antidepressant initiation and appropriate targeting of antidepressants. To address the costly rise in antidepressant prescribing, future research and guidance needs to concentrate on appropriate long term prescribing for depression and regular review of medication

Item Type: Article
Additional Information: CORRECTION: BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b4361 (Published 23 October 2009) Cite this as: BMJ 2009; 339: b4361
ISSNs: 0959-8138 (print)
1468-5833 (electronic)
Related URLs:
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RS Pharmacy and materia medica
Z Bibliography. Library Science. Information Resources > ZA Information resources > ZA4450 Databases
Divisions: University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
Faculty of Medicine > Primary Care and Population Sciences
ePrint ID: 143599
Date Deposited: 12 Apr 2010 13:15
Last Modified: 23 Jun 2014 13:42
URI: http://eprints.soton.ac.uk/id/eprint/143599

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