– A cross-sectional study at the Primary Health Care of Reykjavik capital area

Background: According to research findings, the financial crisis hitting Iceland in the autumn of 2008 caused both economic and health-related effects on the Icelandic population. It has been well known that the Icelandic population uses more antidepressants, anxiolytics and hypnotics compared to other Nordic countries. The aim of this research was to study the trend in prescription for these drugs by the Primary Health Care of Reykjavik capital area to young adults, during the years prior to and following the crisis.

Method: In this cross-sectional study, data were gathered on all medical prescriptions of antidepressants, anxiolytics and hypnotics, prescribed by the Primary Health Care of Reykjavik capital area to people aged 18-35, during 2006-2016. While Reykjavík capital residents in the specified age group were approximately 55 thousand during the research period, this study included data on approximately 23 thousand individuals, received from the Icelandic electronical medical record system “Saga” used by the Primary Health Care.

Results: Research results demonstrate a significant average annual increase of prescribed defined daily doses (DDD) for all three medication categories during the research period; 3% (p<0,001) for anxiolytics, 1.6% (p<0,001) for hypnotics and 10.5% (p<0,001) for antidepressants. Between 2008-2009, prescribed daily doses of anxiolytics increased by 22.7% (p<0,001), where a 12.9% (p<0,001) increase was seen for women and 39.5% (p<0,001) increase for men. Of those men who were prescribed anxiolytics in 2009, 35% had no history of such prescriptions the previous year. From 2006-2008 an average annual increase of 13.6% (p<0,001) was seen in prescribed daily doses of hypnotics, whereof 24.4% (p<0,001) increase was seen for men and 7.8% (p<0,001) for women.

Conclusions: This study demonstrates a significant increase in prescribed amount of hypnotics and anxiolytics during the years prior and after the economic crisis, with more prominent results amongst men compared to women. This trend was however not observed for antidepressants, which could suggest an overall tendency towards short- and fast acting drug prescriptions as a treatment for challenging difficult personal circumstances during the economic crisis in Iceland.

Table I   Number of individuals, prescriptions and DDD from 2006-2016. Individuals aged 18-35, who were prescribed anxiolytics, hypnotics and antidepressants at the Primary Health Care of Reykjavik capital area during the years 2006-2016.

Figure I  Number of psychotropic drug prescriptions. Individuals aged 18-35, who were prescribed anxiolytics, hypnotics and antidepressants at the Primary Health Care of Reykjavik capital area during the years 2006-2016.

Figure II   Antidepressants, number of prescriptions. Individuals aged 18-35, who were prescribed antidepressants at the Primary Health Care of Reykjavik capital area during the years 2006-2016.

Figure III   Selective serotonin reuptake inhibitors, DDD/1000 inhabitants/day. Individuals aged 18-35, who were prescribed selective serotonin reuptake inhibitors at the Primary Health Care of Reykjavik capital area during the years 2006-2016.

Figure IV   Anxiolytics, DDD/1000 inhabitants/day. Individuals aged 18-35, who were prescribed anxiolytics at the Primary Health Care of Reykjavik capital area during the years 2006-2016.

Figure V   Hypnotics and sedatives, DDD/1000 inhabitants/day. Individuals aged 18-35, who were prescribed hypnotics and sedatives at the Primary Health Care of Reykjavik capital area during the years 2006-2016.