Antidepressant drug use in Lombardy, Italy: a population-based study.

BACKGROUND: The patterns of antidepressant drug prescribing have rarely been studied in large and geographically defined catchment areas. In the present study, we examined the prevalence and distribution of antidepressant prescribing in Lombardy, a northern Italy region of nine million inhabitants.

METHODS: This study used the Regional Administrative Database of Lombardy. This database includes all prescriptions reimbursed by the National Health System in the population living in this region. All antidepressant prescriptions dispensed from the 1st January to the 31st December 2001 were extracted and prevalence data calculated by dividing antidepressant users by the total number of male and female residents in each age group.

RESULTS: During the study period, 404,238 individuals were dispensed antidepressants, yielding a prevalence of use of 2.85 (95% confidence interval 2.84, 2.87) per 100 males and 5.92 (95% confidence interval 5.90, 5.94) per 100 females. The prevalence of use progressively rose with age in both sexes, with the highest rates in old and very old individuals. The majority of individuals received a pharmacological treatment with selective-serotonin reuptake inhibitors only, slightly more than 12% received a treatment with tricyclic antidepressants. General practitioners issued the majority of antidepressant prescriptions.

CONCLUSIONS: The very high rates of antidepressant drug prescribing detected in late life suggest the need of characterising these individuals in terms of medical and psychiatric characteristics, needs and quality of life. It also suggests the need for pragmatic clinical trials, carried out in the general practice, with the aim of assessing whether antidepressants are effective in these conditions.