Psychotropic medication use in Canada.
BACKGROUND
Psychotropic medication use can be employed as an indicator of appropriate treatment for mental disorders. The Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) offers the first opportunity to characterize Canadian psychotropic medication use on a national level within diagnostic groups as assessed by a full version of the Composite International Diagnostic Interview (CIDI).


METHODS
We assessed the prevalence of antidepressant, sedative-hypnotic, mood stabilizer, psychostimulant, and antipsychotic use over 2 days overall and in subgroups defined by CIDI-diagnosed disorders and demographics. We employed sampling weights and bootstrap methods.


RESULTS
Overall psychotropic drug utilization was 7.2%. Utilization was higher for women and with increasing age. With any lifetime CIDI-diagnosed disorder assessed in the CCHS 1.2, utilization was 19.3%, whereas without such disorders, it was 4.1%. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly used antidepressants for those with a past-year major depressive episode (17.8%), followed by venlafaxine (7.4%). Among people aged 15 to 19 years, antidepressant use was 1.8% overall and 11.7% among those with past-year depression; SSRIs made up the majority of use. Sedative-hypnotics were used by 3.1% overall, increasing with age to 11.1% over 75 years.


CONCLUSIONS
International comparison is difficult because of different evaluation methods, but antidepressant use may be higher and antipsychotic use lower in Canada than in recent European and American reports. In light of the relative lack of contemporary evidence for antidepressant efficacy in adolescents, it is likely that antidepressant use among those aged 15 to 19 years will continue to decline. The increased use of sedative-hypnotics with age is of concern, given the associated risk of adverse effects among seniors.
Beck
Cynthia A
CA
Department of Psychiatry, University of Calgary, Alberta. cindy.beck@calgaryhealthregion.ca
Williams
Jeanne V A
JV
Wang
Jian Li
JL
Kassam
Aliya
A
El-Guebaly
Nady
N
Currie
Shawn R
SR
Maxwell
Colleen J
CJ
Patten
Scott B
SB
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012494:Sampling Studies
D011619:Psychotropic Drugs