Antidepressant Drug Utilization Study

Antidepressant Use in Denmark, Germany, Spain, and Sweden from 2009 to 2014: Incidence and Comorbidities of Antidepressant Initiators 

Joan Forns, Anton Pottegård, Tammo Reinders, Beatriz Poblador-Plou, Rosa Morros, Lena Brandt, Miguel Cainzos-Achirica, Maja Hellfritzsch, Tania Schink, Alexandra Prados-Torres, Maria Giner-Soriano, David Hägg, Jesper Hallas, Jordi Cortés, Emmanuelle Jacquot, Nicolas Deltour, Susana Perez-GutthannManel Pladevall, Johan Reutfors


Antidepressants are among the most prescribed drugs in Europe. However, no studies have described their use and the characteristics of adult users in Europe since 2012. In the framework of a collaborative study, we conducted a drug utilization study in 5 databases in Denmark, Germany, Spain, and Sweden from 2009 to 2014. 

We included 10 antidepressants, and cumulative incidence of antidepressant initiation was calculated. Also, characteristics of antidepressant users and patterns of use were characterized.

Main results of the study are: 

  • Citalopram and mirtazapine had the highest cumulative incidence, and agomelatine and fluoxetine had the lowest.
  • Most antidepressants users were women.
  • Mirtazapine use was common in older users with a higher presence of comorbidities while fluoxetine use was common in younger users with fewer comorbidities.
  •  Citalopram and mirtazapine were used as first-line treatment, and agomelatine and duloxetine were used as second-line treatment.

Based on the results of the study, we concluded that citalopram and mirtazapine were the most commonly prescribed antidepressants in the populations studied and that age, presence of comorbidities, and patterns of use in adult initiators differed between antidepressants.