Consumption of antidepressants in Italy: Recent trends and their significance for public health

Objectives: The study assessed the consumption of antidepressants in Italy between 2000 and 2011 and identified trends in use. Methods: Data on use of antidepressant drugs between 2000 and 2011 were collected from the Italian Medicines Agency database. Data were expressed as the daily defined dose (DDD) per 1,000 inhabitants. Trends in drug consumption were ascertained by logarithmic transformation of incidence rates by using the formula ln(y)=b x x, where y is the incidence rate, b is the regression coefficient, and x represents the calendar years. Time trends were expressed as expected annual percentage change (EAPC). A significance level of .05 was chosen. Results: Antidepressant consumption increased drastically between 2000 and 2011, from 8.18 to 36.12 DDD per 1,000 inhabitants per day. A single joinpoint (time point with a significant trend change) occurred in 2002 (EAPC=56.4%, 2000-2002, and 6.2%, 2002-2011). The trend analysis stratified by type of drug showed a huge increase in consumption of selective serotonin reuptake inhibitors and other antidepressants and a decrease in consumption of tricyclic antidepressants. Conclusions: Mental disorders are less stigmatized now than in the past. In Italy and elsewhere, antidepressant use is growing, and it would be important to monitor this trend, especially considering the possible effects of the current economic crisis on mental health. In this scenario, the role of public health in mental health promotion has become fundamental.