Pharmacoepidemiological patterns of antidepressant prescribing in primary care in rural Spain (1995-1999)

The prescribing of psychoactive drugs is increasing progressively in western countries. The new psychiatric care modalities, in contact with the primary care centres and closer to the population, might be determining this increase in a major way.

Official data of prescription were collected from the Public Primary Care Department of Pharmacy, to monitor the use of antidepressants during a five year period in a rural health area (140,359 inhabitants). Daily defined dosage (DDD) was used as the measuring unit.

The total use of antidepressants increased progressively during the period studied from 10.47 DDD/1000 inhabitants/day in 1995 to 18.50 in 1999 (an increase of 77.08%). The majority of this increase is explained by the greater use of SSRIs for which prescribing multiplied by 2.5. It is significant that the figure for the use of tricyclics has not fallen parallel to the increase of SSRIs. General practitioners might be losing their fear of diagnosing and treating mood disorders. Probably a pool of patients is included who were not receiving the correct treatment a few years ago, but to what level are we going to lower the symptomatic threshold for prescribing antidepressants?