Prescribing Mental Health

Statistical Publication Notice

16 December 2008

Medicines used in Mental Health 

INTRODUCTION

KEY POINTS

• The prescribing of hypnotics, anxiolytics and barbiturates declined slightly between 2006/07 and 2007/08 by 0.3%, from 2.13 million items to 2.12 million items.
• The volume of medicines indicated for depression rose between 2006/07 and 2007/08 from 3.65 to 3.83 million items; an increase of 4.7%.
• The volume of medicines indicated for psychoses and related disorders rose between 2006/07 and 2007/08 from 670,842 to 693,436 items; an increase of 3.4%.
• Prescriptions for medicines used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) increased by 12.3%, from 59,461 to 66,756 prescribed items between 2006/07 and 2007/08.
• Prescriptions dispensed for medicines indicated for dementia increased by 14.5%, from 83,643 to 95,809 prescribed items between 2006/07 and 2007/08.

INTERPRETATION

• Changes in the number of individuals receiving medication
• The differences for those drugs, which are being prescribed by shorter intervals

DETAILED FINDINGS

• Prescribing of hypnotic drugs, used in the treatment of insomnia, fell by 30.1%, down from 1.56 million items in 1992/93 to 1.09 million in 2007/08.
• Use of the benzodiazepine ? Temazepam, has declined by 64% since 1992/93, but is still the second most commonly prescribed hypnotic.
• Prescribing of Zopiclone ? a non benzodiazepine, has increased nearly seven fold since 1992/93 and for the first time, in 2007/08 it is the most commonly prescribed hypnotic.

• Prescribing of anxiolytic drugs, indicated for anxiety and insomnia, has increased by 0.3% between 2006/07 and 2007/08, up from 1.026 million to 1.029 million items.
• Overall the volume of prescribed anxiolytics has increased by 31.5% from 1992/93 to 2007/08.
• Diazepam is the most commonly prescribed anxiolytic drug, comprising 81.8% of all anxiolytic prescribing.

• Barbiturate prescribing continues to decrease, down from 1,860 to 1,318 items between 2006/07 and 2007/08.
• Overall the prescribing of barbiturates has fallen by 89.9% since 1992/93 to 2007/08.
• Medical opinion is that barbiturates should only be used in the treatment of severe, intractable insomnia in those patients already taking barbiturates and their use should be avoided in the elderly.

• Between 2006/07 and 2007/08 the volume of prescribed drugs indicated for psychoses and related disorders increased by 3.4% up from 670,842 to 693,436 items.
• Prescribing of antipsychotic drugs (BNF 4.2.1) shows a volume increase of 3.8% between 2006/07 and 2007/08, up from 567,568 to 589,405 items.
• Antipsychotic depot injections (BNF 4.2.2) prescribing increased by 1.4%, from 11,292 to 11,445 items between 2006/07 and 2007/08.
• Prescribing of antimanic drugs (BNF 4.2.3) shows a slight increase of 0.7% from 2006/07 to 2007/08, rising to 92,586 items.
• The newer atypical antipsychotic drugs account for 64.8% of all antipsychotic (BNF 4.2.1) prescribing in 2007/08.
• Quetiapine shows the largest increase in use between 2006/07 and 2007/08, from 97,810 items prescribed in 2006/07 to 123,420 items in 2007/08.

• Over the period 1992/93 to 2007/08 the volume of prescribed medicines indicated for depression has more than tripled, growing from 1.16 million to 3.83 million items.
• It is estimated that 9.3% of the Scottish population aged 15 and over make daily use of an antidepressant drug.
• Gross Ingredient Cost of antidepressant medicines in 2007/08 was £40.4 million, down from £43.7 million in the previous financial year.  The decrease is attributable to a number of drugs being reduced in price.
• Prescribing of the two main types of antidepressant drugs, the older tricylics and the ?newer? Selective Serotonin Re-uptake Inhibitors (SSRIs) increased by 1.6% and 5.6% repectively from 2006/07 to 2007/08.  Monoamine ?oxidase Inhibitor (MAOI) prescribing fell by 6.5% and the antidepressant category ?Other? (which do not fall into any of the above category), increased by 8.8% during the same period.

• The prescribing of drugs indicated for Attention Deficit Hyperactivity Disorder (ADHD) grew by 12.3% between 2006/07 and 2007/08, up from 59,461 to 66,756 prescribed items.
• The Modified Release (MR) forms of Methylphenidate now accounts for 62.8% of all Methylphenidate prescribing.
• The Gross Ingredient Cost (GIC) of CNS stimulants, and other drugs used for ADHD increased by 15.4% between 2006/07 and 2007/08, up from £2.50 million to £2.88 million.
• The largest single user in 2007/08 of ADHD drugs is NHS Fife with 241 prescribed items per 1000 population aged 5 to 14.  The Scottish average for the same period was 116 prescribed items per 1000 population aged 5 to 14.

• 95,809 prescriptions were issued in 2007/08 for drugs indicated for dementia, an increase of 14.5% on 2006/07.
• Prescribing of Memantine, the only drug licensed for moderate to severe Alzheimer?s disease, grew by 5.9%, from 2,978 items in 2006/07 to 3,154 items in 2007/08.
• The Gross Ingredient Cost (GIC) of medicines indicated for the treatment of dementia increased between 2006/07 and 2007/08 from 8.78 million to 10.15 million; an increase of 15.6%.

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MAIN CONTACTS:

Jane Chisholm
Principal Information Analyst
0131 275 6197
Healthcare Information Group (Prescribing)
Jane.Chisholm@isd.csa.scot.nhs.uk

Victoria Hepworth
Information Analyst/Statistician
0131 275 6225
Healthcare Information Group (Prescribing)
Victoria.Hepworth@isd.csa.scot.nhs.uk

Nadiya Choudhry
Senior Analyst
0131 275 6140
Healthcare Information Group (Prescribing)
Nadiya.Choudhry@isd.csa.scot.nhs.uk

Iain Bishop
Principal Pharmacist, prescribing
0131 275 6509
Healthcare Information Group
Iain.Bishop@isd.csa.scot.nhs.uk

GLOSSARY:

PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:

HISTORY OF THIS PUBLICATION:

Last Published: 18/12/2007
Next Due: 15/12/2009
Data Avaliable Since: 16/12/2005

Main contact: Victoria Hepworth

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