The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

Abstract

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

Prescription of anxiolytics, sedatives, hypnotics and antidepressants in outpatient, universal care during the COVID-19 pandemic in Portugal: a nationwide, interrupted time-series approach

“…Although an increasing trend in the prescription of antidepressants can be noted throughout the period prior to the pandemic, 12 an immediate decrease in prescription is noted among adolescents and elderly women, which, similar to the prescription of anxiolytics, sedatives and hypnotics, might be associated with the decreased number of doctor visits and improvement in the mental health of the elderly. 34 38 39…”

“…11 Furthermore, poor access to prompt non-pharmacological therapy within the Portuguese National Health System (NHS) may explain the increasing consumption of anxiolytics, sedatives, hypnotics and antidepressants. 12 …”

Prevalence, progress, and subgroup disparities in pharmacological antidepressant treatment of those who screen positive for depressive symptoms: A repetitive cross-sectional study in 19 European countries

“… 34 , 35 , 41 Older populations are more likely to present with multiple diseases resulting in polypharmacy, and are more likely to suffer cognitive and functional impairment. Physicians may, as a result, be reluctant to prescribe antidepressant medications to avoid potential adverse drug–drug reactions, or may prefer psychological therapies because of the suboptimal effectiveness of antidepressant medications among frail individuals with cognitive and functional impairment 42 , 43 , 44 ; patient preference in considering of benefits and adverse effects of antidepressant use versus psychological therapies may also contribute. 45 , 46 Alternatively, these findings could also indicate inappropriate under-prescription of antidepressants to the older population, as suggested by findings from Germany (using data from 2008 to 2010) and the United States (using data from 2004 to 2005).…”

Adaptation of Lipid Profiling in Depression Disease and Treatment: A Critical Review

“…This disease affects around 280 million people worldwide, which corresponds to 3.8% of the population, being one of the main causes of morbidity and disability in the world [2]. It is expected to become one of the main global burden of diseases by 2030 [3]. Due to the high prevalence of disability that translates in low productivity, and significant health and economic costs [4], MDD is considered one of the primary causes of the economic burden of disease worldwide [5].…”