(75) Use of Psychotropic and Antidepressant Medicines in The Brazilian Amazon: Analysis of Two Cross-Sectional Population-Based Studies, 2015 and 2019

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1120

Presenting Author(s)

Tais Freire Galvao
– State University of Campinas, Campinas, S�o Paulo, Brazil

Co-Author(s)

Gustavo Magno B. Tiguman
– State University of Campinas, Brazil
Marcus Silva
– Pharmaceutical Sciences Graduate Course, University of Sorocaba, sorocaba, Sao Paulo, Brazil

Background: The burden of mental disorders is increasing worldwide. Psychotropic medicines are commonly used to treat these conditions, but their use is less frequent in vulnerable settings.

Objectives: To assess the prevalence of psychotropic and antidepressant use and associated factors in two periods.

Methods: This is an analysis of two cross-sectional studies conducted in Manaus in 2015 and 2019. Adults (≥18 years) were selected by a three-phase probabilistic sampling at home. The primary outcome was the prevalence of psychotropic use in the previous 15 days; psychotropic medicines were considered if the reported medicines belonged to the Anatomical Therapeutic Classifications N02A, N03, N04, N05 and N06 (including N06A: antidepressants). Poisson regression with robust variance was used to obtain the prevalence ratios (PR) with 95% confidence intervals (95%CI). A subgroup analysis of antidepressants was also conducted. All analyses were conducted with Stata 14.2 and considered the complex sampling design.

Results: In total, 5,800 participants were included (3,479 in 2015 and 2,321 in 2019). Psychotropic drugs were used by 2.03% of participants in 2015 and 2.66% in 2019. Antidepressant use increased from 0.4% (2015) to 1.4% (2019). In both surveys, antidepressants, antiepileptics, and antipsychotics were the most used drugs. The use of psychotropic drugs was lower in younger (PR=0.41; 95%CI 0.19-0.90), partnerless (PR=0.64; 95%CI 0.44-0.93), and informal workers (PR=0.47; 95%CI 0.25-0.86), but higher in people with poor health (PR=2.86; 95%CI 1.71-4.80), who visited the doctor (PR=3.04; 95%CI 1.45-6.38) and the dentist (PR=1.50; 95%CI 1.08-2.10), and with multimorbidity (PR=3.24; 95%CI 1.87-5.60). Antidepressant use was higher in 2019 (PR=2.90; 95%CI 1.52-5.54), individuals with poor health (PR=2.77; 95%CI 1.16-6.62), and multimorbidity (PR=8.72; 95%CI 2.71-28.00), while lower in informal workers (PR=0.33; 95%CI 0.12-0.87), and unemployed (PR=0.26; 95%CI 0.08-0.81).

Conclusions: The use of psychotropic medicines remained stable in Manaus, while the use of antidepressants tripled from 2015 to 2019. Psychotropic and antidepressant use was mainly driven by socioeconomic and health-related factors, which may indicate barriers in the access to mental health services, particularly among vulnerable individuals.