Antidepressant use in Denmark, Germany, Spain, and Sweden between 2009 and 2014

Incidence and comorbidities of antidepressant initiators

Joan Forns*, Anton Pottegård, Tammo Reinders, Beatriz Poblador-Plou, Rosa Morros, Lena Brandt, Miguel Cainzos-Achirica, Maja Hellfritzsch, Tania Schink, Alexandra Prados-Torres, Maria Giner-Soriano, David Hägg, Jesper Hallas, Jordi Cortés, Emmanuelle Jacquot, Nicolas Deltour, Susana Perez-Gutthann, Manel Pladevall, Johan Reutfors

*Corresponding author for this work

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Abstract

Background: We aimed to describe patterns of use and characteristics of 10 commonly used antidepressants for the period 2009–2014 in Denmark, Germany, Spain, and Sweden. Methods: Adult initiators from 2009 to 2014 of each study antidepressant were identified in four countries using five data sources: the Danish National registers, GePaRD (Germany), EpiChron (Aragon, Spain), SIDIAP (Catalonia, Spain), and the Swedish National Registers. The study included 10 study antidepressants: citalopram, escitalopram, fluoxetine, paroxetine, sertraline, duloxetine, venlafaxine, amitriptyline, mirtazapine, and agomelatine. Results: Citalopram was the most prescribed study antidepressant, followed by mirtazapine. Paroxetine and agomelatine were the least prescribed antidepressants. Mirtazapine was widely used among older antidepressant initiators with higher percentages of comorbidities at baseline, and fluoxetine was used among young patients. Citalopram and amitriptyline had the lowest percentage of multiple antidepressant use in the 12 months prior to the current treatment episode, while agomelatine, duloxetine, and venlafaxine had the highest percentage of multiple antidepressant use in the year prior to the current treatment episode. Limitations: The most important limitations are exposure information based on filled prescriptions, focus on antidepressant initiators only, lack of information on the indication, and heterogeneity of the type of data across data sources. Conclusions: Results of this study including 4.8 million study antidepressant initiators of study antidepressants suggest that citalopram and mirtazapine are the most commonly prescribed antidepressants. Agomelatine and paroxetine were the least used antidepressants in the participating populations. Mirtazapine was the antidepressant most commonly prescribed among older antidepressant initiators with high percentage of comorbidities at baseline, whereas fluoxetine was commonly used among young patients.

Original languageEnglish
JournalJournal of Affective Disorders
Volume249
Pages (from-to)242-252
ISSN0165-0327
DOIs
Publication statusPublished - 2019

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Denmark
Germany
Comorbidity
Incidence
S 20098
Citalopram
Paroxetine
Fluoxetine
Amitriptyline
Information Storage and Retrieval
Sertraline
Prescriptions

Keywords

  • Antidepressants
  • Comorbidity
  • Drug utilization study
  • Europe

Cite this

Forns, Joan ; Pottegård, Anton ; Reinders, Tammo ; Poblador-Plou, Beatriz ; Morros, Rosa ; Brandt, Lena ; Cainzos-Achirica, Miguel ; Hellfritzsch, Maja ; Schink, Tania ; Prados-Torres, Alexandra ; Giner-Soriano, Maria ; Hägg, David ; Hallas, Jesper ; Cortés, Jordi ; Jacquot, Emmanuelle ; Deltour, Nicolas ; Perez-Gutthann, Susana ; Pladevall, Manel ; Reutfors, Johan. / Antidepressant use in Denmark, Germany, Spain, and Sweden between 2009 and 2014 : Incidence and comorbidities of antidepressant initiators. In: Journal of Affective Disorders. 2019 ; Vol. 249. pp. 242-252.
@article{73fc9eb409344549adefc90b48611f18,
title = "Antidepressant use in Denmark, Germany, Spain, and Sweden between 2009 and 2014: Incidence and comorbidities of antidepressant initiators",
abstract = "Background: We aimed to describe patterns of use and characteristics of 10 commonly used antidepressants for the period 2009–2014 in Denmark, Germany, Spain, and Sweden. Methods: Adult initiators from 2009 to 2014 of each study antidepressant were identified in four countries using five data sources: the Danish National registers, GePaRD (Germany), EpiChron (Aragon, Spain), SIDIAP (Catalonia, Spain), and the Swedish National Registers. The study included 10 study antidepressants: citalopram, escitalopram, fluoxetine, paroxetine, sertraline, duloxetine, venlafaxine, amitriptyline, mirtazapine, and agomelatine. Results: Citalopram was the most prescribed study antidepressant, followed by mirtazapine. Paroxetine and agomelatine were the least prescribed antidepressants. Mirtazapine was widely used among older antidepressant initiators with higher percentages of comorbidities at baseline, and fluoxetine was used among young patients. Citalopram and amitriptyline had the lowest percentage of multiple antidepressant use in the 12 months prior to the current treatment episode, while agomelatine, duloxetine, and venlafaxine had the highest percentage of multiple antidepressant use in the year prior to the current treatment episode. Limitations: The most important limitations are exposure information based on filled prescriptions, focus on antidepressant initiators only, lack of information on the indication, and heterogeneity of the type of data across data sources. Conclusions: Results of this study including 4.8 million study antidepressant initiators of study antidepressants suggest that citalopram and mirtazapine are the most commonly prescribed antidepressants. Agomelatine and paroxetine were the least used antidepressants in the participating populations. Mirtazapine was the antidepressant most commonly prescribed among older antidepressant initiators with high percentage of comorbidities at baseline, whereas fluoxetine was commonly used among young patients.",
keywords = "Antidepressants, Comorbidity, Drug utilization study, Europe",
author = "Joan Forns and Anton Potteg{\aa}rd and Tammo Reinders and Beatriz Poblador-Plou and Rosa Morros and Lena Brandt and Miguel Cainzos-Achirica and Maja Hellfritzsch and Tania Schink and Alexandra Prados-Torres and Maria Giner-Soriano and David H{\"a}gg and Jesper Hallas and Jordi Cort{\'e}s and Emmanuelle Jacquot and Nicolas Deltour and Susana Perez-Gutthann and Manel Pladevall and Johan Reutfors",
year = "2019",
doi = "10.1016/j.jad.2019.02.010",
language = "English",
volume = "249",
pages = "242--252",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

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Forns, J, Pottegård, A, Reinders, T, Poblador-Plou, B, Morros, R, Brandt, L, Cainzos-Achirica, M, Hellfritzsch, M, Schink, T, Prados-Torres, A, Giner-Soriano, M, Hägg, D, Hallas, J, Cortés, J, Jacquot, E, Deltour, N, Perez-Gutthann, S, Pladevall, M & Reutfors, J 2019, 'Antidepressant use in Denmark, Germany, Spain, and Sweden between 2009 and 2014: Incidence and comorbidities of antidepressant initiators', Journal of Affective Disorders, vol. 249, pp. 242-252. https://doi.org/10.1016/j.jad.2019.02.010

Antidepressant use in Denmark, Germany, Spain, and Sweden between 2009 and 2014 : Incidence and comorbidities of antidepressant initiators. / Forns, Joan; Pottegård, Anton; Reinders, Tammo; Poblador-Plou, Beatriz; Morros, Rosa; Brandt, Lena; Cainzos-Achirica, Miguel; Hellfritzsch, Maja; Schink, Tania; Prados-Torres, Alexandra; Giner-Soriano, Maria; Hägg, David; Hallas, Jesper; Cortés, Jordi; Jacquot, Emmanuelle; Deltour, Nicolas; Perez-Gutthann, Susana; Pladevall, Manel; Reutfors, Johan.

In: Journal of Affective Disorders, Vol. 249, 2019, p. 242-252.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Antidepressant use in Denmark, Germany, Spain, and Sweden between 2009 and 2014

T2 - Incidence and comorbidities of antidepressant initiators

AU - Forns, Joan

AU - Pottegård, Anton

AU - Reinders, Tammo

AU - Poblador-Plou, Beatriz

AU - Morros, Rosa

AU - Brandt, Lena

AU - Cainzos-Achirica, Miguel

AU - Hellfritzsch, Maja

AU - Schink, Tania

AU - Prados-Torres, Alexandra

AU - Giner-Soriano, Maria

AU - Hägg, David

AU - Hallas, Jesper

AU - Cortés, Jordi

AU - Jacquot, Emmanuelle

AU - Deltour, Nicolas

AU - Perez-Gutthann, Susana

AU - Pladevall, Manel

AU - Reutfors, Johan

PY - 2019

Y1 - 2019

N2 - Background: We aimed to describe patterns of use and characteristics of 10 commonly used antidepressants for the period 2009–2014 in Denmark, Germany, Spain, and Sweden. Methods: Adult initiators from 2009 to 2014 of each study antidepressant were identified in four countries using five data sources: the Danish National registers, GePaRD (Germany), EpiChron (Aragon, Spain), SIDIAP (Catalonia, Spain), and the Swedish National Registers. The study included 10 study antidepressants: citalopram, escitalopram, fluoxetine, paroxetine, sertraline, duloxetine, venlafaxine, amitriptyline, mirtazapine, and agomelatine. Results: Citalopram was the most prescribed study antidepressant, followed by mirtazapine. Paroxetine and agomelatine were the least prescribed antidepressants. Mirtazapine was widely used among older antidepressant initiators with higher percentages of comorbidities at baseline, and fluoxetine was used among young patients. Citalopram and amitriptyline had the lowest percentage of multiple antidepressant use in the 12 months prior to the current treatment episode, while agomelatine, duloxetine, and venlafaxine had the highest percentage of multiple antidepressant use in the year prior to the current treatment episode. Limitations: The most important limitations are exposure information based on filled prescriptions, focus on antidepressant initiators only, lack of information on the indication, and heterogeneity of the type of data across data sources. Conclusions: Results of this study including 4.8 million study antidepressant initiators of study antidepressants suggest that citalopram and mirtazapine are the most commonly prescribed antidepressants. Agomelatine and paroxetine were the least used antidepressants in the participating populations. Mirtazapine was the antidepressant most commonly prescribed among older antidepressant initiators with high percentage of comorbidities at baseline, whereas fluoxetine was commonly used among young patients.

AB - Background: We aimed to describe patterns of use and characteristics of 10 commonly used antidepressants for the period 2009–2014 in Denmark, Germany, Spain, and Sweden. Methods: Adult initiators from 2009 to 2014 of each study antidepressant were identified in four countries using five data sources: the Danish National registers, GePaRD (Germany), EpiChron (Aragon, Spain), SIDIAP (Catalonia, Spain), and the Swedish National Registers. The study included 10 study antidepressants: citalopram, escitalopram, fluoxetine, paroxetine, sertraline, duloxetine, venlafaxine, amitriptyline, mirtazapine, and agomelatine. Results: Citalopram was the most prescribed study antidepressant, followed by mirtazapine. Paroxetine and agomelatine were the least prescribed antidepressants. Mirtazapine was widely used among older antidepressant initiators with higher percentages of comorbidities at baseline, and fluoxetine was used among young patients. Citalopram and amitriptyline had the lowest percentage of multiple antidepressant use in the 12 months prior to the current treatment episode, while agomelatine, duloxetine, and venlafaxine had the highest percentage of multiple antidepressant use in the year prior to the current treatment episode. Limitations: The most important limitations are exposure information based on filled prescriptions, focus on antidepressant initiators only, lack of information on the indication, and heterogeneity of the type of data across data sources. Conclusions: Results of this study including 4.8 million study antidepressant initiators of study antidepressants suggest that citalopram and mirtazapine are the most commonly prescribed antidepressants. Agomelatine and paroxetine were the least used antidepressants in the participating populations. Mirtazapine was the antidepressant most commonly prescribed among older antidepressant initiators with high percentage of comorbidities at baseline, whereas fluoxetine was commonly used among young patients.

KW - Antidepressants

KW - Comorbidity

KW - Drug utilization study

KW - Europe

U2 - 10.1016/j.jad.2019.02.010

DO - 10.1016/j.jad.2019.02.010

M3 - Journal article

VL - 249

SP - 242

EP - 252

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -