Trends and variation in antidepressant prescribing in English primary care: a retrospective longitudinal study

Background Antidepressants are commonly prescribed. There clear national guidelines in relation to treatment sequencing. This study examines trends and variation antidepressant prescribing across English primary care. Aim To examine England, with a focus on: monoamine oxidase inhibitors (MAOIs); paroxetine; dosulepin trimipramine. Design & settin g Retrospective longitudinal using practice-level data on items prescribed per year (1998–2018) month (2010–2019). Method Class- drug-specific proportions were calculated at practice levels. Descriptive statistics generated, percentile charts maps plotted, logistic regression analysis was conducted. Results Antidepressant prescriptions more than tripled between 1998 2018, from 377 1000 population 1266 1000. MAOI fell substantially, 0.7% of all 0.1% 2018. marked practices past paroxetine (median proportion [MPP] = 1.7%, interdecile range [IDR] 2.6%) (MPP 0.7%, IDR 1.8%), but less for trimipramine 0%, 0.2%). Conclusion Rapid growth substantial behaviour found practices. The causes could be explored mixed-methods research. Interventions reduce specific antidepressants, such as dosulepin, include review prompts, alerts the time prescribing, clinician feedback through tools like OpenPrescribing.net.