Analysis of OECD data shows that European countries have seen a dramatic increase in the use of antidepressants since 2000 – but rates vary widely between countries
"The data on European countries does not suggest that the happier people are the less they consume antidepressants." Euronews report on antidepressant use
Use of antidepressants increased by nearly two and a half times between 2000 and 2020 in 18 European countries, Organization for Economic Cooperation and Development (OECD) data shows.
OECD data also reveals a dramatic increase in anxiety and depression during the COVID‑19 pandemic.
The datasets used by the OECD use the term “defined daily dose” or DDD to quantify antidepressant consumption. In 2000, the average antidepressant consumption across 18 European countries was 30.5 DDD per 1,000 people. In 2020, that rose to 75.3 DDD, an increase of nearly 150% (or two-and-a-half times).
Behind these average figures, however, are very different starting points. In 2000, Estonia had 6.4 DDD per 1,000 people, while in Iceland the figure was 70.5 DDD.
Even in 2020, the figure between countries vary widely. The country with the highest consumption of antidepressants was Iceland, with 153 DDD per 1,000 people. The lowest was Hungary, with 30 DDD. (Latvia had 20 DDD, but the figure was for 2012 rather than 2020.)
After Iceland, the three countries with the highest rates of antidepressant consumption are Portugal (131 DDD), the UK (108 DDD – though this figure is for 2017), Sweden (105 DDD) and Spain (87 DDD).
In 2020, the average use across 24 countries was 68 DDD. The largest three countries by population – Turkey (49 DDD), France (55 DDD) and Germany (62 DDD) – all recorded below average use.
The biggest increase in the 20-year period was in the Czech Republic, where usage rose by 577%. It was lowest in France (38%), though from a higher baseline.
The countries spending the most on antidepressants in 2020 were Germany (€783 million), Spain (€626 million) and Italy €440 million).
An analysis by Euronews looked at whether there was a correlation between low use of antidepressants and reported levels of happiness. The answer was no: Iceland – the second happiest country in the world in 2020 according the World Happiness Report – has the highest antidepressant consumption in Europe.
Sweden, ranked sixth in the Happiness Report, has the fourth highest use of antidepressants with105 DDD.
Surveys released by the OECD suggest that mental health has deteriorated significantly since the start of the Covid-19 pandemic. The prevalence of anxiety in early 2020 was double or more than double that observed in previous years in Belgium, France, Italy, Mexico, New Zealand, the UK and the US.
Similarly, between 2019 and 2021, there was an increase of 10% or more in consumption of antidepressant drugs in the 14 OECD countries for which data is available. However, as the earlier figures show, there has been a steady increase in the consumption of antidepressants consumption over the last 20 years, so the recent rise cannot necessarily be attributed to the pandemic.
This analysis from Euronews of the change in antidepressant use over time has some fascinating findings. Iceland, Portugal, the UK, Sweden and Spain all have high rates of antidepressant consumption, and in some countries the rise since 2000 has been more dramatic than in others – the 577% rise in the Czech Republic is in striking contrast to the 38% rise in France.
The general trend, however, is upwards: there are no European countries in which antidepressant consumption has dropped. The difficulty for the observer is in knowing the reasons behind the increase – are people becoming more depressed, or simply more comfortable about seeking treatment? It may be that the availability of new, more effective antidepressant drugs has played a part, or that doctors, following clinical guidelines, feel more willing to prescribe antidepressants. Knowing the answer would enable us to determine whether this is a worrying trend – showing a rise in clinical depression – or one to be welcomed as the result of more people accessing medical treatment for their illness.
It would also be useful to see figures on access to talking therapies, to see whether these have increased at a similar rate, or whether antidepressants are being used to some extent as a substitute for the more expensive talking therapies.