Prevalence of Antidepressant Prescriptions for Community-Dwelling Adults Diagnosed with Depressive Disorder in the UK: A Systematic Review

Overview

Journal Psychiatr Q

Specialty Psychiatry

Date 2024 Sep 30

PMID 39347894

Authors

Lea Francia

Roberto Mediavilla

Lok Yin Choi

Jose Luis Ayuso-Mateos

Riccardo De Giorgi

Affiliations

Soon will be listed here.

Abstract

The UK National Institute for Health and Care Excellence (NICE) guidance for the treatment of depression is widely followed and has international influence. According to these guidelines, antidepressant medications are recommended for moderate to severe depression. Nonetheless, antidepressants are increasingly prescribed, including for cases of subthreshold and mild depression. This may indicate that a proportion of depressed patients uses pharmacological interventions with unclear evidence-base, though other factors such as physical and mental health comorbidities need to be accounted for. This study aims to investigate the prevalence and trends of antidepressant prescriptions among community-dwelling adults diagnosed with depression according to NICE recommendations. We conducted a systematic review of PsycInfo, PubMed/MEDLINE, and Scopus databases. Observational studies reporting on the prevalence of antidepressant treatments in UK adults diagnosed with depression were sought. Fifteen studies were included. The prevalence of antidepressants for depression treatment ranged from 30.8 to 95% and mainly concerned selective serotonin reuptake inhibitors (SSRIs) among classes of antidepressant drugs. Little information about depression severity as well as comorbid conditions was reported. High prevalence rates of antidepressant drug use highlight the widespread adoption of pharmacological interventions, while also raising concerns about compliance with NICE guidelines. Careful assessment of depressive illness severity and comorbidities is needed to ensure the delivery of adequate care to people with depression. Systematic Review Registration Number (PROSPERO) CRD42023448152.

References

Moreno-Agostino D, Wu Y, Daskalopoulou C, Hasan M, Huisman M, Prina M . Global trends in the prevalence and incidence of depression:a systematic review and meta-analysis. J Affect Disord. 2020; 281:235-243. DOI: 10.1016/j.jad.2020.12.035. View

Arias-de la Torre J, Ronaldson A, Prina M, Matcham F, Pinto Pereira S, Hatch S . Depressive symptoms during early adulthood and the development of physical multimorbidity in the UK: an observational cohort study. Lancet Healthy Longev. 2021; 2(12):e801-e810. PMC: 8636278. DOI: 10.1016/S2666-7568(21)00259-2. View

Zhang R, Peng X, Song X, Long J, Wang C, Zhang C . The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population. Psychol Med. 2022; 53(8):3611-3620. PMC: 10277767. DOI: 10.1017/S0033291722000241. View

Mekonen T, Chan G, Connor J, Hides L, Leung J . Estimating the global treatment rates for depression: A systematic review and meta-analysis. J Affect Disord. 2021; 295:1234-1242. DOI: 10.1016/j.jad.2021.09.038. View

Qaseem A, Owens D, Etxeandia-Ikobaltzeta I, Tufte J, Cross Jr J, Wilt T . Nonpharmacologic and Pharmacologic Treatments of Adults in the Acute Phase of Major Depressive Disorder: A Living Clinical Guideline From the American College of Physicians. Ann Intern Med. 2023; 176(2):239-252. DOI: 10.7326/M22-2056. View

Cipriani A, Furukawa T, Salanti G, Chaimani A, Atkinson L, Ogawa Y . Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018; 391(10128):1357-1366. PMC: 5889788. DOI: 10.1016/S0140-6736(17)32802-7. View

Fournier J, DeRubeis R, Hollon S, Dimidjian S, Amsterdam J, Shelton R . Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA. 2010; 303(1):47-53. PMC: 3712503. DOI: 10.1001/jama.2009.1943. View

Kirsch I, Deacon B, Huedo-Medina T, Scoboria A, Moore T, Johnson B . Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med. 2008; 5(2):e45. PMC: 2253608. DOI: 10.1371/journal.pmed.0050045. View

Baumeister H . Inappropriate prescriptions of antidepressant drugs in patients with subthreshold to mild depression: time for the evidence to become practice. J Affect Disord. 2011; 139(3):240-3. DOI: 10.1016/j.jad.2011.05.025. View

10.

Davidson S, Romaniuk H, Chondros P, Dowrick C, Pirkis J, Herrman H . Antidepressant treatment for primary care patients with depressive symptoms: Data from the longitudinal cohort study. Aust N Z J Psychiatry. 2020; 54(4):367-381. DOI: 10.1177/0004867419898761. View

11.

Lunghi C, Dugas M, Leclerc J, Poluzzi E, Martineau C, Carnovale V . Global prevalence of antidepressant drug utilization in the community: protocol for a systematic review. BMJ Open. 2022; 12(5):e062197. PMC: 9157341. DOI: 10.1136/bmjopen-2022-062197. View

13.

Kendrick T . Strategies to reduce use of antidepressants. Br J Clin Pharmacol. 2020; 87(1):23-33. DOI: 10.1111/bcp.14475. View

14.

Haidich A . Meta-analysis in medical research. Hippokratia. 2011; 14(Suppl 1):29-37. PMC: 3049418. View

15.

Lensen S . When to pool data in a meta-analysis (and when not to)?. Fertil Steril. 2023; 119(6):902-903. DOI: 10.1016/j.fertnstert.2023.03.015. View

16.

Tamblyn R, Bates D, Buckeridge D, Dixon W, Forster A, Girard N . Multinational comparison of new antidepressant use in older adults: a cohort study. BMJ Open. 2019; 9(5):e027663. PMC: 6530307. DOI: 10.1136/bmjopen-2018-027663. View

17.

Siraj R, McKeever T, Gibson J, Bolton C . Incidence of depression and antidepressant prescription in patients with COPD: A large UK population-based cohort study. Respir Med. 2022; 196:106804. DOI: 10.1016/j.rmed.2022.106804. View

18.

Frolkis A, Vallerand I, Shaheen A, Lowerison M, Swain M, Barnabe C . Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression. Gut. 2018; 68(9):1606-1612. DOI: 10.1136/gutjnl-2018-317182. View

19.

Dearman S, Waheed W, Nathoo V, Baldwin R . Management strategies in geriatric depression by primary care physicians and factors associated with the use of psychiatric services: a naturalistic study. Aging Ment Health. 2006; 10(5):521-4. DOI: 10.1080/13607860600637984. View

20.

Yang L, Deng Y, Leng Y, Ou Y, Li Y, Chen S . Depression, Depression Treatments, and Risk of Incident Dementia: A Prospective Cohort Study of 354,313 Participants. Biol Psychiatry. 2022; 93(9):802-809. DOI: 10.1016/j.biopsych.2022.08.026. View

21.

Weich S, Morgan L, King M, Nazareth I . Attitudes to depression and its treatment in primary care. Psychol Med. 2007; 37(9):1239-48. DOI: 10.1017/S0033291707000931. View