Psychotropic consumption before and during COVID-19 in Asturias, Spain

Abstract

Background Spain as multiple other countries has been experiencing an increasing and sustained trend in the use of psychotropic medications since the mid 90s. Recent studies show public health measures implemented to control SARS-Cov2, such as mobility restrictions and the shutdown of nonessential activities increased mental suffering, even contributing to a higher number of anxiety, depression and insomnia disorders that could lead to an increase in the consumption of psychotropics. The aims were: 1) Evaluate the temporal trend in psychotropic consumption by pharmacological subgroup, sex, and age group 2) Estimate the effect of the COVID-19 pandemic in the use of psychotropic drugs. Methods We conducted a retrospective observational study, retrieving all prescriptions of anxiolytics, hypnotics and sedatives, and antidepressants dispensed in pharmacies of Asturias (Northern Spain) for Primary Care patients for the period 2018–2021. We presented the data expressed in Daily Defined Doses (DDDs) for 1000 persons/day (DHD). To estimate changes in DHDs by year and age group we conducted two multiple linear regressions (one for males and one for females) for every pharmacological subgroup studied. Changes were considered statistically significant when the regression coefficient was p < 0.05. We used the Software R 4.1.0. Results For the studied period, the highest DHDs are for antidepressants, although all of the subgroups experienced an increase in consumption rates. Women consumed more psychotropic drugs than men. In 2021, 372 out of every 1000 women were taking daily 1 DDD of these drugs versus 184 out of every 1000 men. Consumption rates for all psychotropic drugs progressively increases with age. Conversely, the biggest increases in consumption were among the youngest age groups (0–14 and 15–29 years) for women, while for men there is more variability. The regression models suggest an upward trend in psychotropic consumption during all the period, especially remarkable from 2020, for both genders and all age groups. Conclusions - The consumption of psychotropic drugs has gradually increased over the last 4 years, with a significant boost starting in 2020 for both sexes, matching the start of the SARS-COV2 pandemic and the implementation of strict Public Health measures to contain it. - The increase observed on children and adolescents is a matter of concern.

Increased prescribing of psychotropic medication for children and adolescents during the COVID‐19 pandemic: no cause for alarm

“…Two investigations reported in this issue of the MJA compared the rates of prescribing and dispensing of psychotropic medications for children and adolescents in Australia during the early years of the COVID‐19 pandemic with rates prior to the pandemic 2,3 . The authors used different methodologies, but both studies found that rates were higher than usual during the pandemic, findings consistent with those of similar studies in Scandinavia 1,4 and Spain 5 . Differences by gender and age conformed with known morbidity patterns under non‐pandemic conditions.…”

Psychotropic Medication Prescribing for Children and Adolescents After the Onset of the COVID-19 Pandemic

“… 22 , 23 Numerous studies worldwide have reported increases mainly in the prevalence of anxiety and depressive symptoms in young people 24 , 25 and in the number of hospitalizations and emergency department visits for severe mood disorders and suicidality in the year following the pandemic onset. 10 , 26 , 27 , 28 , 29 Consequent increments in psychotropic medication prescribing have been observed, often after a transient decrease during strict lockdowns, 11 , 12 , 13 , 30 , 31 but few studies have data to report on persisting effects associated with the pandemic. A Danish study 32 reported increases in the incident use of psychotropic medications (18%), mainly hypnotics, antidepressants, and psychostimulants, among children and adolescents up to mid-2022.…”

“…Population-based studies have reported increases in the uptake of antidepressants and hypnotics among youths (<18 or 19 years) in the months following the pandemic onset . Increases in overall psychotropic medication consumption, more important in the youngest age groups, were estimated at 35% among children 10 to 14 years of age and 15 to 19 years . However, data on psychotropic medication use in children and adolescents long after the pandemic onset are currently lacking.…”

“… 8 , 9 , 10 Increases in overall psychotropic medication consumption, more important in the youngest age groups, were estimated at 35% among children 10 to 14 years of age and 15 to 19 years. 11 , 12 , 13 However, data on psychotropic medication use in children and adolescents long after the pandemic onset are currently lacking. The purpose of the present study was to assess the rates and trends of psychotropic medication prescribing for children and adolescents before and in the 2 years after the onset of the COVID-19 pandemic in France.…”

Psychopharmacoepidemiological trends in the Portuguese territory during the pandemic and post-pandemic periods (2019–2022)

“…Other countries have reported generalised increased consumption of psychotropic drugs during and after the COVID-19 pandemic, namely Croatia [35], France [3, 19], Spain [10] and Brazil [6].…”