title: Influences on antidepressant prescribing trends in the UK: 1995-2011.
abstract: The number of antidepressants prescribed in the UK has been increasing over the last 25 years; however, the reasons for this are not clear. This study examined trends in antidepressant prescribing in the UK between 1995 and 2011 according to age, sex, and drug class, and investigated reasons for the increase in prescribing over this period.
  
  
  
  This is a retrospective analysis of antidepressant prescribing data from the Clinical Practice Research Datalink: a large, anonymised, primary care database in the UK. The dataset used in this study included 138 practices, at which a total of 1,524,201 eligible patients were registered across the 17-year period. The proportion of patients who received at least one antidepressant prescription and the number of patients who started a course of antidepressants were calculated for each year of the study. We used person years (PY) at risk as the denominator. The duration of treatment for those starting antidepressants was also examined.
  
  
  
  23% of patients were prescribed an antidepressant on at least one occasion over the 17-year study period. Antidepressant prescriptions rose from 61.9 per 1000 PY in 1995 to 129.9 per 1000 PY in 2011. This was largely driven by an increase in prescribing of selective serotonin reuptake inhibitors and 'other' antidepressants. In contrast, incidence rates of those starting antidepressants remained relatively stable (1995: 21.3 per 1000 PY; 2011: 17.9 per 1000 PY). The duration of treatment increased with later starting years, with an increasing proportion of long-term use, and decrease in short-term use.
  
  
  
  The increase in antidepressant prescribing over the study period appears to be driven by an increase in long-term use of these medications.
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK. becky.mars@bristol.ac.uk.
authors.forename: Becky
authors.identifier: 0000-0002-8132-6920
authors.initials: B
authors.lastname: Mars
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Heron
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
authors.forename: David
authors.initials: D
authors.lastname: Kessler
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.|MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
authors.forename: Neil M
authors.initials: NM
authors.lastname: Davies
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Martin
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
authors.forename: Kyla H
authors.initials: KH
authors.lastname: Thomas
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000706:statistics & numerical data* / Q000639:trends; D012189:Retrospective Studies; D006113:United Kingdom
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; General practice; Prescribing; Primary care; Trends