Trends in antidepressant drug utilization in Sweden since 1977

Background: Antidepressant medications are widely prescribed in Sweden, yet comprehensivelongitudinal studies examining trends in their utilization over time are scarce. This thesisaddresses this gap by exploring the patterns of antidepressant drug utilization in Sweden from1977 to 2023. Aims: The primary aim of this study is to investigate the longitudinal trends in antidepressantutilization across different demographic groups, including age and gender, and various categoriesof antidepressants. Methods: A quantitative-descriptive repeated cross-sectional design is employed, utilizingaggregated sales data from 1977 to 2000 and prescription data from 2006 to 2023. Defined DailyDose per 1000 inhabitants per day (DDD/TID) and Patients per 1000 inhabitants are used asprincipal analytical metrics. The study population comprises all men and women of all ages whoobtained at least one prescription for antidepressants during the study period. Results: The analysis reveals a notable escalation in antidepressant consumption over the studyperiod. Sales statistics indicate a significant increase in antidepressant usage from approximately6 DDD/TID in 1977 to 48 DDD/TID by 2000. Prevalence data from 2006 to 2023 shows a rise inpatients per 1000 inhabitants, reaching 114 in 2023, with women receiving more prescriptionsthan men nearly doubling that of men by 2023. Selective Serotonin Reuptake Inhibitors(SSRIs)(N06AB) experienced a significant increase between 1992 and 2000, while TricyclicAntidepressants (TCAs) declined gradually. Other antidepressants (N06AX) also showed a slowincrease, competing with SSRIs by 2023. Antidepressant usage was higher among adults,particularly those over 60, compared to younger individuals. Conclusion: This thesis underscores the evolving landscape of antidepressant drug utilization inSweden, highlighting the need for tailored interventions to address demographic-specific patternsand optimize mental health care delivery.