Background: Antidepressant drugs are important in the treatment of major depression. The use of antidepressants in general and more specifically selective serotonin reuptake inhibitors (SSRIs) has, however, been subject to discussion since their introduction in Norway in 1990. After the introduction of paroxetin in Norway in 1993, the sales of SSRIs rose rapidly. Up until now we have had little knowledge of the patterns of use of these drugs in Norway. This article describes the sales of SSRIs and other antidepressants from 1990 to 2004. The newly established Norwegian Prescription Database (NorPD) is used to establish the figures in more detail.
Material and methods: Sales figures for SSRIs and other antidepressants from the Norwegian Institute of Public Health are presented. NorPD is used to describe age and gender prevalence and incidence of antidepressant use.
Results: After their introduction on the Norwegian drug market in the beginning of the 1990s, the SSRIs have held a leading position on this market. In the beginning, paroxetin was the prevalent drug used in Norway. When citalopram was marketed in 1995, it rapidly took over this role. From 2004 escitalopram won a growing share of the market. Two thirds of all antidepressants are prescribed to women. With increasing age, increasing shares of the population are prescribed antidepressants. Elderly people are prescribed relatively more tricyclic antidepressants than younger people. SSRIs are also prescribed to adolescents, though tricyclic antidepressants are predominant below the age of 15.
Interpretation: A lower increase in the sales of antidepressants in 2004 could be caused by saturation of the antidepressants market or negative media attention for these drugs. Tricyclic antidepressants are possibly still used in excess by the elderly. The number of girls 15-19 years of age using SSRIs is relatively large. Even though fluoxetin is the only drug recommended for this age group, other SSRIs are more often prescribed.