Psychotropic Medication Use Before and During COVID-19: A Population-Wide Study

Christine Leong; Kaarina Kowalec; Sherif Eltonsy; James M Bolton; Murray W Enns; Qier Tan; Marina Yogendran; Dan Chateau; Joseph A Delaney; Jitender Sareen; Jamison Falk; Rae Spiwak; Sarvesh Logsetty; Silvia Alessi-Severini

doi:10.3389/fphar.2022.886652

Psychotropic Medication Use Before and During COVID-19: A Population-Wide Study

Front Pharmacol. 2022 Apr 27:13:886652. doi: 10.3389/fphar.2022.886652. eCollection 2022.

Authors

Christine Leong^{1

2}, Kaarina Kowalec^{1

3}, Sherif Eltonsy¹, James M Bolton^{2

4

5}, Murray W Enns², Qier Tan⁶, Marina Yogendran⁶, Dan Chateau⁷, Joseph A Delaney^{1

8}, Jitender Sareen^{2

4

5}, Jamison Falk¹, Rae Spiwak⁹, Sarvesh Logsetty^{2

9}, Silvia Alessi-Severini¹

Affiliations

¹ College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
² Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
³ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
⁴ Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
⁵ Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.
⁶ Manitoba Centre for Health Policy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
⁷ Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
⁸ Department of Epidemiology, University of Washington, Seattle, WA, United States.
⁹ Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic and public health measures that took place have led to concerns regarding mental health and receipt of psychotropic medications. We aimed to study the changes in psychotropic medication dispensation rates before and during the COVID-19 pandemic in the general population. Methods: Administrative health data from the Canadian province of Manitoba was used to describe the quarterly incidence and prevalence of antipsychotics, antidepressants, and anxiolytic/sedative-hypnotics from January 1, 2015 to December 31, 2020. Individuals who received at least one prescription within each quarter were considered exposed to the medication. The denominator was the total population within each quarter. Incidence was defined as no receipt of medication in the 3 years prior to the quarter of interest. Autoregression models for time series data plus indicator variables were used to compare each quarter of 2020 after public health measures were implemented in March 2020 in relation to the expected trend. Analyses were stratified by age and sex. Results: There were 1,394,885 individuals in the first quarter of 2020, with a mean (SD) age of 38.9 (23.4) years, 50.3% were female, and 36.1% had a psychiatric diagnosis in the previous 5 years. A significant decrease was observed for incident antidepressant use (p < 0.05 for both sexes and all age groups except for those 65 years and older) and anxiolytic use (p < 0.05 for both sexes and all age groups except 80 years and older) in the second quarter (April-June) of 2020 compared to the expected trend. Females and those aged 40 years and older had a significantly higher incidence of antidepressant and antipsychotic use in the final quarter of 2020 compared to the expected trend (p < 0.05). Conclusion: Our findings indicate a decrease in new prescriptions for antidepressants and anxiolytics in the 3 months after COVID-19 in-person restrictions were first implemented. We then observed an increase in the new use of antidepressants and antipsychotics at the end of 2020, in females and people aged 40 years and older, with the highest rates of use in the population 80 years and older.

Keywords: COVID-19; drug utilization; pandemic; population-wide study; psychotropic drugs.