Prevalence, trends, and individual patterns of long-term antidepressant medication use in the adult Swiss general population

Eur J Clin Pharmacol. 2023 Nov;79(11):1505-1513. doi: 10.1007/s00228-023-03559-4. Epub 2023 Sep 5.

Abstract

Purpose: Antidepressant use has increased in many European countries, mostly driven by longer treatment duration. The aim of this study was to provide prevalence rates of long-term users of antidepressants for the Swiss population over the last decade and to investigate associated factors for longer use.

Methods: We examined the prevalence rates of individuals with at least one prescription for antidepressants using longitudinal health claims data for 2013 to 2021. We defined short- (< one year), medium- (one-two years), and long-term users (> two years) for 2015 to 2019. We applied a binary logistic regression model to investigate the effects of population (gender, age, area of living, language, health insurance plan, and nursing home) and treatment characteristics (psychiatric or psychotherapeutic care) on long-term compared to short- and medium-term users in 2019.

Results: In 2021, 9% of the Swiss population (n = 770,698) received at least one antidepressant prescription, which remained stable since 2013. In 2019, the proportion of long-term users was 57.4%, with steady increase since 2015. The proportion of medium- and short-term users has decreased. Older age, being a woman, living in an urban area, living in a nursing home, being enrolled in a standard care plan, and receiving psychiatric or psychotherapeutic care were factors positively associated with being a long-term user.

Conclusion: The proportion of long-term users in Switzerland is high and steadily increasing. Given the ongoing debate about the confounding effects of relapse and withdrawal, more research is needed to investigate longer use of antidepressants that could indicate overprescribing.

Keywords: Antidepressants; Long-term use; Pharmacoepidemiology; Time trend.

MeSH terms

  • Adult
  • Antidepressive Agents* / therapeutic use
  • Europe
  • Female
  • Humans
  • Male
  • Prevalence
  • Psychotropic Drugs*
  • Switzerland / epidemiology

Substances

  • Antidepressive Agents
  • Psychotropic Drugs