Editing Antidepressant (section)

===Prescription trends===

==== United Kingdom ====
In the UK, figures reported in 2010 indicated that the number of antidepressants prescribed by the [[National Health Service]] (NHS) almost doubled over a decade.<ref>{{cite news|vauthors=Davis R|date=11 June 2010|title=Antidepressant Use Rises as Recession Feeds Wave of Worry|newspaper=The Guardian|location=London|url=https://www.theguardian.com/society/2010/jun/11/antidepressant-prescriptions-rise-nhs-recession|url-status=live|access-date=1 July 2010|archive-url=https://web.archive.org/web/20100615165456/http://www.guardian.co.uk/society/2010/jun/11/antidepressant-prescriptions-rise-nhs-recession|archive-date=15 June 2010}}</ref> Further analysis published in 2014 showed that number of antidepressants dispensed annually in the community went up by 25 million in the 14 years between 1998 and 2012, rising from 15 million to 40 million. Nearly 50% of this rise occurred in the four years after the [[Great Recession]], during which time the annual increase in prescriptions rose from 6.7% to 8.5%.<ref>{{cite web|vauthors=Spence R|title=Focus on: Antidepressant prescribing|url=http://www.qualitywatch.org.uk/focus-on/antidepressant-prescribing|url-status=live|archive-url=https://web.archive.org/web/20150204194028/http://www.qualitywatch.org.uk/focus-on/antidepressant-prescribing|archive-date=4 February 2015|access-date=12 January 2015|website=QualityWatch|publisher=QualityWatch (Nuffield Trust/Health Foundation)}}</ref> These sources also suggest that aside from the recession, other factors that may influence changes in prescribing rates may include: improvements in diagnosis, a reduction of the [[Social stigma|stigma]] surrounding mental health, broader prescribing trends, GP characteristics, geographical location, and housing status. Another factor that may contribute to increasing consumption of antidepressants is the fact that these medications now are used for other conditions including [[social anxiety]] and [[post-traumatic stress disorder]].

Between 2005 and 2017, the number of adolescents (12 to 17 years) in England who were prescribed antidepressants has doubled. On the other hand, antidepressant prescriptions for children aged 5–11 in England decreased between 1999 and 2017.<ref>{{cite journal|date=18 November 2020|title=Teenagers' use of antidepressants is rising with variations across regions and ethnic groups|url=https://evidence.nihr.ac.uk/alert/teenagers-use-of-antidepressants-is-rising-with-variations-across-regions-and-ethnic-groups/|journal=NIHR Evidence|type=Plain English summary|publisher=National Institute for Health and Care Research|doi=10.3310/alert_42239|s2cid=240759939}}</ref><ref>{{cite journal|vauthors=Jack RH, Hollis C, Coupland C, Morriss R, Knaggs RD, Butler D, Cipriani A, Cortese S, Hippisley-Cox J|title=Incidence and prevalence of primary care antidepressant prescribing in children and young people in England, 1998–2017: A population-based cohort study|journal=PLOS Medicine|volume=17|issue=7|pages=e1003215|date=July 2020|pmid=32697803|pmc=7375537|doi=10.1371/journal.pmed.1003215|veditors=Hellner C|doi-access=free}}</ref> From April 2015, prescriptions increased for both age groups (for people aged 0 to 17) and peaked during the first COVID lockdown in March 2020.<ref>{{cite web|vauthors=Robinson J|title=Peaks in number of young people prescribed antidepressants coincide with lockdowns|url=https://pharmaceutical-journal.com/article/news/peaks-in-number-of-young-people-prescribed-antidepressants-coincide-with-lockdowns|access-date=4 November 2022|website=The Pharmaceutical Journal|date=23 June 2021}}</ref>

According to [[National Institute for Health and Care Excellence]] (NICE) guidelines, antidepressants for children and adolescents with depression and obsessive-compulsive disorder (OCD) should be prescribed together with therapy and after being assessed by a [[Child and adolescent psychiatry|child and adolescent psychiatrist]]. However, between 2006 and 2017, only 1 in 4 of 12–17 year-olds who were prescribed an SSRI by their GP had seen a specialist psychiatrist and 1 in 6 has seen a pediatrician. Half of these prescriptions were for depression and 16% for anxiety, the latter not being licensed for treatment with antidepressants.<ref name="NIHR-2022"/><ref>{{cite journal|vauthors=Jack RH, Joseph RM, Coupland C, Butler D, Hollis C, Morriss R, Knaggs RD, Cipriani A, Cortese S, Hippisley-Cox J|title=Secondary care specialist visits made by children and young people prescribed antidepressants in primary care: a descriptive study using the QResearch database|journal=BMC Medicine|volume=18|issue=1|pages=93|date=April 2020|pmid=32349753|pmc=7191694|doi=10.1186/s12916-020-01560-7|doi-access=free}}</ref> Among the suggested possible reasons why GPs are not following the guidelines are the difficulties of accessing talking therapies, long waiting lists, and the urgency of treatment.<ref name="NIHR-2022" /><ref>{{cite web|date=4 November 2022|title=GPs giving antidepressants to children against guidelines|url=https://www.theguardian.com/society/2022/nov/04/gps-giving-antidepressants-to-children-against-guidelines|access-date=5 November 2022|website=The Guardian}}</ref> According to some researchers, strict adherence to treatment guidelines would limit access to effective medication for young people with mental health problems.<ref>{{cite journal|vauthors=Walkup JT, Strawn JR|title=High-quality antidepressant prescribing: please consider whether "perfection is the enemy of progress"|journal=BMC Medicine|volume=18|issue=1|pages=150|date=May 2020|pmid=32438910|pmc=7243321|doi=10.1186/s12916-020-01621-x|doi-access=free}}</ref>

==== United States ====
In the United States, antidepressants were the most commonly prescribed medication in 2013.<ref name="AJantidepressantstatsUS" /> Of the estimated 16 million "long term" (over 24 months) users, roughly 70 percent are female.<ref name="AJantidepressantstatsUS">{{cite web|vauthors=White R|title=Waking up from sadness: Many find trouble getting off antidepressants|url=http://america.aljazeera.com/articles/2014/1/22/patients-mostly-womenfindtroublegettingoffofantidepressants.html|publisher=Al Jazeera|access-date=8 June 2014|url-status=live|archive-url=https://web.archive.org/web/20140714142717/http://america.aljazeera.com/articles/2014/1/22/patients-mostly-womenfindtroublegettingoffofantidepressants.html|archive-date=14 July 2014}}</ref> {{As of|2017}}, about 16.5% of white people in the United States took antidepressants compared with 5.6% of black people in the United States.<ref name="APP2017">{{cite web|title=By the numbers: Antidepressant use on the rise|url=https://www.apa.org/monitor/2017/11/numbers.aspx|website=apa.org|access-date=1 February 2019}}</ref>

[[File:Sertraline2DACS2.svg|thumb|alt=<!--empty-->|link=<!--empty-->|class=skin-invert-image|Structural formula of the SSRI [[sertraline]]]]

'''United States:''' The most commonly prescribed antidepressants in the US retail market in 2010 were:<ref>{{cite web|title=Top 200 generic drugs by units in 2010|url=http://drugtopics.modernmedicine.com/drugtopics/data/articlestandard//drugtopics/252011/727243/article.pdf|archive-url=https://web.archive.org/web/20121215070930/http://drugtopics.modernmedicine.com/drugtopics/data/articlestandard//drugtopics/252011/727243/article.pdf|archive-date=15 December 2012}}{{cite web|title=Top 200 brand drugs by units in 2010|url=http://drugtopics.modernmedicine.com/drugtopics/data/articlestandard//drugtopics/252011/727256/article.pdf|archive-url=https://web.archive.org/web/20120422181417/http://drugtopics.modernmedicine.com/drugtopics/data/articlestandard//drugtopics/252011/727256/article.pdf|archive-date=22 April 2012}}</ref>

{| class="wikitable sortable"
|-
! scope="col" | '''Drug name'''
! scope="col" | '''Drug class'''
! scope="col" | '''Total prescriptions'''
|-
| [[Sertraline]]
| [[SSRI]]
| 33,409,838
|-
| [[Citalopram]]
| [[SSRI]]
| 27,993,635
|-
| [[Fluoxetine]]
| [[SSRI]]
| 24,473,994
|-
| [[Escitalopram]]
| [[SSRI]]
| 23,000,456
|-
| [[Trazodone]]
| [[Serotonin antagonist and reuptake inhibitor|SARI]]
| 18,786,495
|-
|[[Venlafaxine]] (all formulations)
|[[Serotonin–norepinephrine reuptake inhibitor|SNRI]]
|16,110,606
|-
|[[Bupropion]] (all formulations)
|[[Norepinephrine–dopamine reuptake inhibitor|NDRI]]
|15,792,653
|-
| [[Duloxetine]]
| [[Serotonin–norepinephrine reuptake inhibitor|SNRI]]
| 14,591,949
|-
| [[Paroxetine]]
| [[SSRI]]
| 12,979,366
|-
| [[Amitriptyline]]
| [[Tricyclic antidepressant|TCA]]
| 12,611,254
|-
| [[Venlafaxine]] XR
| [[Serotonin–norepinephrine reuptake inhibitor|SNRI]]
| 7,603,949
|-
| [[Bupropion]] XL
| [[Norepinephrine–dopamine reuptake inhibitor|NDRI]]
| 7,317,814
|-
| [[Mirtazapine]]
| [[Tetracyclic antidepressant|TeCA]]
| 6,308,288
|-
| [[Venlafaxine]] ER
| [[Serotonin–norepinephrine reuptake inhibitor|SNRI]]
| 5,526,132
|-
| [[Bupropion]] SR
| [[Norepinephrine–dopamine reuptake inhibitor|NDRI]]
| 4,588,996
|-
| [[Desvenlafaxine]]
| [[Serotonin–norepinephrine reuptake inhibitor|SNRI]]
| 3,412,354
|-
| [[Nortriptyline]]
| [[Tricyclic antidepressant|TCA]]
| 3,210,476
|-
| [[Bupropion]] ER
| [[Norepinephrine–dopamine reuptake inhibitor|NDRI]]
| 3,132,327
|-
| [[Venlafaxine]]
| [[Serotonin–norepinephrine reuptake inhibitor|SNRI]]
| 2,980,525
|-
| [[Bupropion]]
| [[Norepinephrine–dopamine reuptake inhibitor|NDRI]]
| 753,516
|}

'''Netherlands:''' In the Netherlands, [[paroxetine]] is the most prescribed antidepressant, followed by [[amitriptyline]], [[citalopram]] and [[venlafaxine]].<ref>{{cite web|url=http://www.gipdatabank.nl/index.asp?scherm=tabellenFrameSet&infoType=g&tabel=01-basis&item=N06AB|title=GIPdatabank|publisher=Gipdatabank.nl|access-date=6 November 2008|url-status=dead|archive-url=https://web.archive.org/web/20081206123718/http://www.gipdatabank.nl/index.asp?scherm=tabellenFrameSet&infoType=g&tabel=01-basis&item=N06AB|archive-date=6 December 2008}}</ref>