Antidepressant drug use in Europe: past consumption, prescribing patterns and forecast until 2030.

introductionMental disorders represent a significant global burden, with a high proportion of depressive disorders. Antidepressants (ADs) are the most prescribed drugs for treating mental disorders, with broad indications, e.g. depression, anxiety disorders, and off-label use.

aimThis study assesses current and historical changes in AD consumption in 25 European countries, predicts future developments, and further analyses ATC subgroup consumption in 13 countries.

methodConsumption data for ADs (ATC code N06A) were collected from the OECD Data Explorer. Subgroup data came from publicly available sources. The time span covered is 1980 to 2024. Changes in defined daily doses per 1000 population per day (DID) were analysed, and projections to 2030 were made using Auto Regressive Integrated Moving Average models. Treatment coverage for depressive disorder prevalence was also calculated.

resultsIn 2023, AD consumption ranged from 26.3 DID (Latvia) to 164.7 DID (Iceland). Use increased in nearly all countries, except Luxembourg (- 0.3 DID between 2013 and 2022). Increases ranged from + 5.9% (Austria) to + 157.8% (Latvia). Forecasts predict further increases in most countries (+ 0.1 to + 80.9%), with decreases projected for Hungary, Austria, the UK, and Luxembourg (- 3.4 to - 21.7%). Selective serotonin reuptake inhibitors (SSRIs) are the most used subgroup, with mixed developments. The second most used is miscellaneous, with growing shares in most countries. Non-selective monoamine reuptake inhibitors (NSMRIs) are declining, while monoamine oxidase inhibitors (MAO-Is) and monoamine oxidase A inhibitors (MAOA-Is) have very low shares. Northern Europe shows the highest AD use versus Eastern Europe the lowest. All regions primarily use SSRIs. Northern Europe has a higher miscellaneous share, while Eastern Europe uses more NSMRIs.

conclusionAD use has increased and is projected to continue rising in most countries, with changing subgroup preferences. The dominance of SSRIs reflects first-line treatment recommendations. Increased miscellaneous use may indicate more individualised treatment and better tolerability. NSMRIs are declining due to adverse effects, and MAO-Is as well as MAOA-Is are rarely used due to safety concerns. Prescribing patterns vary across regions, influenced by health systems, cultural differences, stigma, and healthcare resources.