'Steady rise' in use of antidepressants in last five years

New research indicates the pandemic was a 'potential' factor in the 'steady rise' in the use of anti-depressants among Irish medical card holders. Picture: Stock Image

There has been a “steady rise” in the use of anti-depressants among Irish medical card holders over the last five years, according to new research.

The study also reveals growing rates of repeat prescriptions, indicating greater rates of long-term anti-depressant use.

The research said the pandemic was a “potential” factor in the rise.

The study also highlights risks posed by long-term use of anti-depressants.

It calls for more resources for non-drug therapies, more training for GPs on ending prescriptions and information on withdrawal symptoms.

The study was conducted by researchers attached to the University of Limerick’s School of Medicine and Health Research Institute and is published by the Irish Journal of Medical Science.

The academics examined antidepressant (AD) use in general practices in the Midlands between 2016 and 2020, involving a sample of almost 3,000 people.

It said the number of medical cardholders (MCH) prescribed with AD grew from 9.42 per 100 MCH to 12.3 per 100 MCH between 2016 and 2020.

Growing refill rates

“Secondly, it has brought to light the growing rates of antidepressant refill dispensing, indicating greater rates of long-term antidepressant use,” it said.

It said this may be indicative of “chronic depression” or may highlight “a lack of appropriate medication cessation strategies”.

The research said the highest proportion of AD medications which were refills occurred in 2020.

It said previous research showed a 28% increase in the amount of AD prescriptions dispensed between 2012 and 2017 and an 18% rise in patients needing the medication in general practice.

It said HSE data from the Irish Public Care Reimbursement Service reported an “escalation” in both prescribing frequency and total drug expenditure during 2020, in comparison to 2019.

Knowledge 'gap'

In relation to long-term use, the report said there seemed to be a “gap” in current primary care knowledge, specifically pertaining to the withdrawal effects of these psychotropic medications.

It said that a 2019 UK-based survey found that only 17% of GPs believed in the ability to distinguish withdrawal effects from depression relapse.

Over two thirds of the GPs desired more training on the common effects of tapering dosage.

On the impact of Covid-19, it said it was imperative to acknowledge the pandemic as “a potential reasoning” behind the rise in AD rates.

“This yearly growth trend highlights the potential negative impact of mental well-being amongst the Irish population – which appears to be progressing and subsequently now at the highest figures over the five-year period,” it said.

It is plausible that these figures have been influenced by the Covid-19 pandemic. 

The report said their findings highlight a “potential pitfall”, with a lack of appropriate cessation following AD medication use.

The researchers recommended more guidelines on AD prescription, including long-term use, and the promotion of psychological intervention, such as cognitive behaviour therapy.

It said Irish GPs would “likely benefit from greater resources being invested in mental health to improve both access to non-pharmacological therapies and to help disseminate knowledge on deprescribing strategies for ADs when appropriate”.

The study was conducted by Aoibhin McCool and Kurt Lukas of the UL School of Medicine and Peter Hayes and Dervla Kelly of the college's Health Research Institute.

*HSE: yourmentalhealth.ie or 1800 111 888 

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