Key result
Long-term antidepressant use reaches ~69% among treated adults, linked to older age and female sex.
Why the study?
Antidepressant use has risen across Europe primarily due to longer treatment duration, prompting an investigation into prevalence rates and associated factors of long-term antidepressant use in Switzerland over the last decade.
Cohort (n=770,698)
The proportion of long-term antidepressant users in Switzerland is steadily increasing, highlighting a need to investigate potential overprescribing.
Highlights potential overutilization in older adults; leaves open whether long-term use improves outcomes.
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. To compare different lengths of prescription duration, we defined short-term (<6 months), medium-term (6-12 months) and long-term users (>12 months). We applied a binary logistic regression model to investigate the effects of population characteristics and treatment patterns on long-term compared to short- and medium-term users. Results: In 2021, 9% of the Swiss population (n=770 698) received at least one antidepressant prescription. This one-year-prevalence remained stable since 2013. In 2020, the proportion of long-term users was 69.4%, with steady increase from 2014 to 2020. The numbers of medium- and short-term users have decreased during this period. Older age, being a woman, living in an urban area, living in the Italian speaking part of Switzerland, living in a nursing home, being enrolled in a standard care plan, and receiving psychiatric or psychotherapeutic care were factors associated with long-term users. Conclusions: The proportion of long-term users in Switzerland is steadily increasing. Taking antidepressants longer than recommended may indicate possible overprescribing. Given the ongoing debate about the confounding effects of relapse and withdrawal, more research is needed to investigate antidepressants overprescribing, particularly for older people.
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Amrein et al. (2023) conducted a cohort in Antidepressant use (n=770,698). Antidepressant use vs. Unexposed population / Short-term users was evaluated on Proportion of long-term antidepressant users (>12 months) in 2020. In 2020, 69.4% of Swiss adults prescribed antidepressants were long-term users, representing a steady increase since 2014, with older age, female sex, and nursing home residency associated with prolonged use.
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