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Cited by 217Mental Health Treatment and AccessBipolar Disorder and TreatmentPharmaceutical Practices and Patient Outcomes

Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011

Stephenson, Chris P, Karanges, Emily, McGregor, Iain S·2013·Australian & New Zealand Journal of Psychiatry
DOI 10.1177/0004867412466595
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Abstract

Objective: This study examined longitudinal trends in the dispensing of psychotropic medications in Australia from January 2000 to December 2011. Method: Dispensing data for the major classes of psychotropic medications (antidepressants, anxiolytics, sedatives, antipsychotics, mood stabilisers and attention-deficit hyperactivity disorder (ADHD) medications) were obtained from the Drug Utilisation Sub-Committee of the Australian Department of Health and Ageing. Results were expressed in terms of defined daily doses/1000 population/day (DDDs/1000/day). Results: There was a 58.2% increase in the dispensing of psychotropic drugs in Australia from 2000 to 2011, driven by major increases in antidepressants (95.3% increase in DDDs/1000/day), atypical antipsychotics (217.7% increase) and ADHD medications (72.9% increase). Dispensing of anxiolytics remained largely unchanged, while sedatives and typical antipsychotics decreased by 26.4% and 61.2%, respectively. Lithium dispensing remained static while valproate and lamotrigine increased markedly. In 2011, antidepressants accounted for 66.9% of total psychotropic DDDs/1000/day totals, far greater than anxiolytics (11.4%), antipsychotics (7.3%), mood stabilisers (5.8%), sedatives (5.5%), or ADHD medications (3.0%). Sertraline, olanzapine, valproate and methylphenidate were the most frequently dispensed antidepressant, antipsychotic, mood stabiliser and ADHD medication, respectively, while diazepam and temazepam were the most commonly dispensed anxiolytic and sedative. Conclusions: Psychotropic utilisation markedly increased in Australia between 2000 and 2011. Some potential concerns include: (1) the continuing high use of benzodiazepines, particularly alprazolam, despite their problematic effects; (2) the rapid increase in serotonin noradrenaline reuptake inhibitor (SNRI) use, given their more complex side-effect profile relative to selective serotonin reuptake inhibitors (SSRIs); and (3) the dramatic increase in antidepressant prescriptions despite questions about the efficacy of these drugs in mild to moderate depression. Finally, some limitations are identified regarding use of the DDDs/1000/day metric, which can distort estimates of utilisation of specific drugs when the defined daily dose is higher or lower than the formulation most commonly dispensed by pharmacies.

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  • There is a strong reliance on pharmacotherapy as the first-line treatment strategy for some mental illnesses.

    “There appears to be a strong reliance on pharmacotherapy as the fi rst-line treatment strategy for some mental illnesses.”

    From A call to action: Exercise as treatment for patients with mental illness (2015) · cites this paper as Stephenson et al. 2013

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Authors
Stephenson, C. P., Karanges, E., & McGregor, I. S.
Affiliations
The University of Sydney (AU)
ORCID
Venue
Australian & New Zealand Journal of Psychiatry
Publisher
SAGE Publications
Published
2012-11-09
Volume
47
Issue
1
Pages
74-87
ISSN
  • 0004-8674 (ISSN-L)
  • 1440-1614
DOI
10.1177/0004867412466595
OpenAlex
W2067911406
Cited by
217
References
53
Citations by year
2026: 2 · 2025: 5 · 2024: 8 · 2023: 11 · 2022: 14 · 2021: 16 · 2020: 15 · 2019: 14 · 2018: 18 · 2017: 27 · 2016: 22 · 2015: 22 · 2014: 29 · 2013: 14
FWCI
31.37
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Australian & New Zealand Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
antidepressants, atypical antipsychotics, ADHD medication, benzodiazepines, mood stabilizers, defined daily doses, serotonin-norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, lithium, valproic acid, olanzapine, sertraline, diazepam, Australia, drug prescribing
MeSH terms
Central Nervous System Stimulants, Antidepressive Agents, Australia, Drug Utilization, Humans, Hypnotics and Sedatives, Longitudinal Studies, Psychotropic Drugs, Antipsychotic Agents, Anti-Anxiety Agents

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