title: Initial prescription of antipsychotics and antidepressants in general practice and specialist care in Norway.
abstract: OBJECTIVE
  To examine the incidence rates of antipsychotic (AP) and antidepressant (AD) drug treatment in Norway and the proportions initiated in general practice and specialist care respectively.
  
  
  METHODS
  Data on all prescriptions of APs and ADs dispensed to the general population in Norway from 1 January 2004 until 31 August 2009 were extracted from the Norwegian Prescription Database. This information was merged with data about general practitioners (GPs) from the Norwegian Regular General Practitioner Scheme.
  
  
  RESULTS
  One-year incidence rates per 1000 inhabitants were 3.4 for APs and 8.6 for ADs. GPs initiated 58% of APs and 73% of ADs, while psychiatrists initiated 15% and 6% respectively. Psychiatrists initiated treatment more often among younger patients, and they prescribed relatively newer drugs more commonly than GPs. A large share of incident users did not refill their prescriptions for APs (57%) or ADs (33%).
  
  
  CONCLUSIONS
  GPs have a key role as regards initiating treatment with APs and ADs in Norway, while psychiatrists' influence seems limited, particularly among older patients. Efforts for quality improvement of mental health care need to involve primary health care. In addition, an increased focus from psychiatrists towards the increasingly ageing part of the population seems requisite.
authors.affiliation: Research Group for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Norway. svein.kjosavik@isf.uib.no
authors.forename: S R
authors.initials: SR
authors.lastname: Kjosavik
authors.forename: S
authors.initials: S
authors.lastname: Hunskaar
authors.forename: D
authors.initials: D
authors.lastname: Aarsland
authors.forename: S
authors.initials: S
authors.lastname: Ruths
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D009664:Norway; D011570:Psychiatry / Q000706:statistics & numerical data*; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents