Objective: To examine trends in types of antidepressant medications prescribed in Australia between 1975 and 2002.
Design: Sales data from the Australian pharmaceutical industry were used to examine trends in overall antidepressant prescribing and changes in the types of antidepressants prescribed between 1975 and 2002.
Main outcome measures: Antidepressant sales were expressed as defined daily doses (DDDs) per 1000 people per day, using the estimated Australian population for each year obtained from the Australian Bureau of Statistics.
Results: Average annual growth in the sales of antidepressants was 1.1% per year from 1975 to 1990, after which growth rose steeply to reach 29% in 1995. By 2002 the rate of growth had slowed to 6.6%. Eighty per cent of total sales were accounted for by four drugs in 1975, 1980 and 1985; five in 1990; seven drugs in 1995 and 2000; and six drugs in 2001 and 2002.
Conclusions: The rapid growth in antidepressant prescribing that was characteristic of the early 1990s, and reflected the emergence of new classes of agents, did not continue into the late 1990s. Selective serotonin reuptake inhibitors now dominate antidepressant prescribing in Australia.
- 1. McManus P, Mant A, Mitchell PB, et al. Recent trends in the use of antidepressant drugs in Australia, 1990–1998. Med J Aust 2000; 173: 458-461. <MJA full text>
- 2. McManus P, Mant A, Mitchell P, et al. Use of antidepressants by general practitioners and psychiatrists in Australia. Aust N Z J Psychiatry 2003; 37: 184-189.
- 3. Hickie IB, Davenport TA, Naismith SL, et al. Treatment of common mental disorders in Australian general practice. Med J Aust 2001; 175 (2 Suppl): S25-S30.
- 4. Hickie IB. Responding to the Australian experience of depression. Med J Aust 2002; 176 (10 Suppl): S61-S62. <MJA full text>
- 5. Mant A. Thinking about prescribing: a handbook for quality use of medicines. Sydney: McGraw-Hill Australia, 1999; 128-129.
- 6. Avorn J, Chen M, Hartley R. Scientific versus commercial sources of influence on the prescribing behavior of physicians. Am J Med 1982; 73: 4-8.
- 7. Roughead EE, Harvey KJ, Gilbert AL. Commercial detailing techniques used by pharmaceutical representatives to influence prescribing. Aust N Z J Med 1998; 28: 306-310.
- 8. Moynihan R, Heath I, Henry D. Selling sickness: the pharmaceutical industry and disease mongering. BMJ 2002; 324: 886-891.
- 9. WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment. 2nd ed. Oslo: WHO, 2001.
- 10. Mackay FR, Dunn NR, Martin RM, et al. Newer antidepressants: a comparison of tolerability in general practice. Br J Gen Pract 1999; 49: 892-896.
- 11. Mitchell PB. The new antidepressants – are they worth the cost? Aust Prescriber 1995; 18: 82-83.
- 12. Hall WD, Mant A, Mitchell PB, et al. Association between antidepressant prescribing and suicide in Australia, 1991–2000: trend analysis. BMJ 2003; 326: 1008-1012.
- 13. Isacsson G. Suicide prevention – a medical breakthrough? Acta Psychiatr Scand 2000; 102: 113-117.
- 14. Carlsten A, Waern M, Ekedahl A, et al. Antidepressant medication and suicide in Sweden. Pharmacoepidemiol Drug Saf 2001; 10: 525-530.
- 15. Birkett DJ, McManus P. Modelling the market uptake of new drugs following listing for subsidy in Australia. A report from the Drug Utilisation Subcommittee of the Australian Pharmaceutical Benefits Advisory Committee. Br J Clin Pharm 1995; 40: 407-410.
- 16. Naismith SL, Hickie IB, Scott EM, et al. Effects of mental health training and clinical audit on general practitioners’ management of common mental disorders. Med J Aust 2001; 175 (2 Suppl): S42-S47.
- 17. Jorm AF, Medway J, Christensen H, et al. Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Aust N Z J Psychiatry 2000; 34: 619-626.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.