Initiation and duration of selective serotonin reuptake inhibitor prescribing over time: UK cohort study
Open accessAbstract
Background: Recent media reports have focused on the large increase in antidepressants dispensed in England. We investigated this, focusing on selective serotonin reuptake inhibitors (SSRIs). Aims: To examine the rate of initiation of SSRIs over time and changes over time in the duration of prescribing episodes. Method: We estimated initiation and duration of SSRI prescribing from 7 025 802 individuals aged over 18 years and registered with a general practice that contributed data to The Health Improvement Network. Results: Rates of SSRI initiation increased from 1.03 per 100 person-years in 1995 to 2.15 in 2001, but remained stable from then to 2012. The median duration of prescribing episodes increased from 112 to 169 days for episodes starting in 1995 to 2010. Conclusions: Despite media reports describing an increasing rate of antidepressant prescribing, SSRI initiation rates have stabilised since 2001. However, our results suggest that individuals who take SSRIs are receiving treatment for longer.
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In high-income countries, the number of prescriptions for antidepressants has risen during the past several decades, mostly due to an increase in the duration of treatment.
“In high-income countries, the number of prescriptions for these medications has risen during the past several decades, mostly due to an increase in the duration of treatment. 2-5”
From Maintenance or Discontinuation of Antidepressants in Primary Care (2021) · cites this paper as [3]
The Main findings section reports rising antidepressant prescriptions in England and notes similar increases in other OECD countries. The Change in total time and duration of prescribing episodes section says longer SSRI prescribing episodes at least partially explain the UK rise; it does not establish that increased treatment duration was the main cause across high-income countries. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPrimary analyses were rerun classifying relapse according to ICD-10 criteria, and secondary analyses were rerun using log-transformed PHQ-9 and GAD-7 scores.
“In addition, we reran the primary analyses and classified relapse according to ICD-10 depression criteria and reran secondary analyses using log-transformed PHQ-9 and GAD-7 scores that could be compared with prior studies of minimal clinically important differences.”
From Maintenance or Discontinuation of Antidepressants in Primary Care (2021) · cites this paper as [3]
The Statistical analyses and Outcomes of interest sections describe SSRI prescribing episodes and initiation rates, not depression relapse analyses. Searches for ICD-10 relapse criteria, log-transformed PHQ-9 and GAD-7 scores, and minimal clinically important differences found no passage addressing the claim. Page numbers were unavailable in our copy. (LLM, conf=0.76)
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Maintenance or Discontinuation of Antidepressants in Primary Care
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- Authors
- McCrea, R. L., Sammon, C. J., Nazareth, I., & Petersen, I.
- Affiliations
- Aarhus University (DK)
- Corresponding author
- Petersen, Irene
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-11
- Volume
- 209
- Issue
- 5
- Pages
- 421-426
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2513524236
- Cited by
- 40
- References
- 6
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 4 · 2019: 3 · 2018: 7 · 2017: 2
- FWCI
- 6.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Scopus (Elsevier) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0515-10041)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- selective serotonin reuptake inhibitors, antidepressant prescribing, prescribing trends, primary care prescribing, Health Improvement Network
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, United Kingdom, Humans, Male, Middle Aged, Drug Prescriptions, Primary Health Care, Cohort Studies, Selective Serotonin Reuptake Inhibitors, Young Adult, General Practice
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