Increasing Prevalence of Long-Term Antidepressant Use in Australia: A Retrospective Observational Study

Area of Science:

• Epidemiology
• Pharmacology
• Public Health

Background:

• Long-term antidepressant use may negatively impact the risk-benefit balance due to withdrawal symptoms and side effects.
• Defining long-term antidepressant use as continuous use for at least 365 days, with permissible dispensing gaps of up to 60 days.
• Investigating historical trends in long-term antidepressant use within the Australian community from 2014 to 2023.

Purpose of the Study:

• To analyze the epidemiological trends of long-term antidepressant use in Australia.
• To examine age-specific patterns in long-term antidepressant utilization.
• To assess changes in treatment duration and dose reduction strategies over time.

Main Methods:

• Retrospective analysis of a 10% sample of Australian Pharmaceutical Benefits Scheme (PBS) data.
• Inclusion of patients aged over 10 years dispensed PBS-listed antidepressants between January 2014 and December 2023.
• Examination of prevalence, age-stratified trends, treatment duration, and apparent dose reductions.

Main Results:

• Prevalence of long-term antidepressant use rose from 66.1 to 84.6 per 1000 population (2014-2023).
• The 10-24 age group exhibited the highest relative increase in long-term user prevalence (110%) and proportion (35%).
• Average treatment duration increased by 25% overall, with a 56% rise in the 10-24 group; apparent dose reductions remained minimal.

Conclusions:

• A significant increase in long-term antidepressant use across all age groups, particularly adolescents and young adults, was observed.
• Extended treatment durations and limited dose reduction suggest potential overprescription and underutilization of deprescribing.
• There is a need for integrated mental health approaches incorporating effective deprescribing and technological interventions.