Key Information on the Use of Antidepressants in Scotland

SUMMARY POINTS

1. The rise in prescriptions of antidepressants in Scotland is for the most part explained by better diagnosis and treatment of depression by GPs. Research from within academic centres in Scotland confirms that antidepressants are being prescribed in line with currently endorsed clinical guidelines, and improvements in this continue.

2. As we continue to develop and utilise access to CHI-linked prescribing data, we will be able to further analyse prescribing patterns in order to learn more about what influences prescribing choices.

3. There is consistent evidence of under-treatment of depression. And we know that the personal and economic costs of having depression are high. We need to continue to work on ways to improve its recognition and effective treatment.

4. The extent to which factors other than the treatment of depression influence antidepressant prescribing rates such as their use in the treatment of a range of other conditions cannot be clearly ascertained from nationally reported data. Further study using both clinical and research databases is required.

5. Changes in patterns of prescribing (such as seeing more drugs in use as newer drugs are developed) isn't necessarily a bad thing, for example, the availability of SSRIs and their increased use has occurred in parallel with reduced use of older tricyclic anti-depressants in doses commonly used for the treatment of depression. Tricyclics are drugs which have a more unpleasant side effect profile including greater toxicity in overdose.

6. The use of antidepressants by any individual is a dynamic process and varies due to the relapsing and remitting nature of the illness and individual treatment preferences. They don't work for everyone but for those that do respond the evidence for antidepressant treatment reducing relapse is strong.

7. The cost of anti-depressant prescribing is falling as drugs come "off-patent" and less expensive versions become available.

8. There is no evidence that having greater access to psychological therapies will reduce antidepressant prescribing, rather, access to appropriate and effective treatments which will include antidepressants is improved.