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Making new choices about antidepressants in Australia: the long view 1975–2002

Andrea Mant, Valerie A Rendle, Wayne D Hall, Philip B Mitchell, William S Montgomery, Peter R McManus and Ian B Hickie
Med J Aust 2004; 181 (7): 21.

Summary

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.

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  • Andrea Mant1
  • Valerie A Rendle2
  • Wayne D Hall3
  • Philip B Mitchell4
  • William S Montgomery5
  • Peter R McManus6
  • Ian B Hickie7

  • 1 Quality Use of Medicines, South East Health, Sydney Hospital, Sydney, NSW.
  • 2 Albion Street Centre, Prince of Wales Hospital, Surry Hills, NSW.
  • 3 Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD.
  • 4 School of Psychiatry, University of New South Wales, Randwick, NSW.
  • 5 Corporate Affairs and Health Economics, Eli Lilly Australia, West Ryde, NSW.
  • 6 Canberra Hospital, Hughes, ACT.
  • 7 Brain and Mind Research Institute, University of Sydney, Rozelle, NSW.

Correspondence: 

Acknowledgements: 

Funding for the project was provided through a grant from beyondblue: the national depression initiative. This grant met the part-time salary for Ms Rendle, specifically covering data entry and analysis costs. A “strategic fund” for the Vice-Chancellor, University of Queensland, supports the salary of Professor Hall. Retrospective data from IMS Health Australia Pty Ltd were provided at no charge, courtesy of Eli-Lilly Australia Pty Ltd.

Competing interests:

William S Montgomery is an employee of and owns stock in Eli Lilly, manufacturer of fluoxetine (Prozac). Ian Hickie has received honoraria for participation in industry-sponsored scientific meetings, and has participated in educational programs sponsored by Bristol-Myers Squibb, Pfizer and Wyeth.

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