Background: The pattern of use of antidepressive drugs in Spain through 1985-1994 is studied. Special emphasis is given to the impact of selective serotonin re-uptake inhibitors introduction at the end of the eighties.
Material and methods: Information on drug utilization was obtained from the databases of the Ministry of Health which contain the number of packages sold in community pharmacies and charged to the National Health System. Data are expressed in defined daily doses (DDD) per 1,000 inhabitants per day.
Results: The use of antidepressants (excluding fixed-dose combinations) increased from 2.7 DDD/1,000 inhabitants/day in 1985 to 9.3 DDD/1,000 inhabitants/day in 1994 (247%). All the subgroups contributed. Selective serotonin re-uptake inhibitors utilization was 4.71 DDD/1,000 inhabitants/day in 1994, representing 71% of the overall increase during the study period. The consumption of fixed-dose combinations decreased in 17%. Since 1991 fluoxetine is the antidepressant most widely used. The consumption through pensioner prescriptions is proportionally higher for second generation antidepressants than for the other groups.
Conclusions: Antidepressive drugs consumption in Spain increased three times in the last ten years, though it is still below the estimated point prevalence of depression. Selective serotonin re-uptake inhibitors introduction has modified the pattern of use of antidepressants but their impact on the use of the rest of the group has been apparently low.