(195) Differences in Psychotropic Drug Use Among Children and Adolescents in Scandinavia

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1240

Presenting Author(s)

Rikke Wesselhoeft, MD
– Associate Professor, Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, University of Southern Denmark, Odense C, Syddanmark, Denmark

Co-Author(s)

Anne Mette Skov Sørensen
– Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, København NV, Hovedstaden, Denmark
Peter Jensen
– Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Denmark, Denmark
Jacob Harbo Andersen
– University of Southern Denmark, Denmark
Johan Reutfors
– M.D., Ph.D., associate professor, Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden, Sweden
Svetlana Skurtveit
– Department of Mental Disorders, Norwegian Institute of Public Health, Norway, Oslo, Norway
Ingeborg Hartz
– Department of mental disorders, Norwegian Institute of Public Health Norway, Norway
Kari Furu
– Department of Chronic Diseases, Norwegian Institute of Public Health, Norway, Norway
Poul Jørgen Jennum
– Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Glostrup, Denmark, Denmark
Carolyn E. Cesta, PhD
– PhD, Karolinska Institutet, Stockholm, Sweden
Katrine Strandberg-Larsen
– Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark, Denmark
Ardesheer Talati, PhD
– Columbia University, New York, New York, United States
Per Damkier, MD, PhD
– Professor, consultant, Department of Clinical Pharmacology, Odense University Hospital, Denmark and Department of Clinical Research, University of Southern Denmark, Denmark, Denmark
Anton Pottegård, PhD, MSc
– University of Southern Denmark, Odense C, Denmark
Mette Bliddal, PhD
– Associate professor, University of Southern Denmark, University of Southern Denmark, Odense C, Syddanmark, Denmark
Lotte Rasmussen
– University of Southern Denmark, Odense C, Syddanmark, Denmark

Background: The Scandinavian countries (Sweden, Norway and Denmark) have similar health care systems and clinical guidelines for psychotropic treatment in childhood.

Objectives: We compared use of antidepressants, hypnotics and ADHD medications between Scandinavians aged 5-19 years.

Methods: We conducted three separate studies using nationwide aggregate-level data from national prescription databases. Drug use was defined as ≥1 filled prescription within each year. Study 1) examined antidepressant use (selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, ‘other antidepressants’) in 2007-2017. Study 2) examined hypnotic use (melatonin, ‘z-drugs’, sedating antihistamines) in 2012-2018. Study 3) examined use of ADHD medications (central stimulants, atomoxetine and guanfacine) in 2010-2020.
We calculated annual prevalence (users/1,000 inhabitants) stratified by sex, age group and country.

Results: The annual prevalence of antidepressant use, particularly SSRIs, increased markedly from 2007 to 2017 among youths in Sweden (from 9.3 to 18/1,000). Conversely, prevalent antidepressant use was quite stable in Norway (5.1 to 7.6/1,000) and decreased in Denmark (9.3 to 7.5/1,000) throughout the study period. The annual prevalence of hypnotic use, particularly melatonin, increased during 2012-2018 in all Scandinavian countries. The increase was, however, most pronounced in Sweden (6.5 to 25/1,000) compared to Norway (10 to 20/1,000) and Denmark (5.7 to 12/1,000). Similarly, prevalent use of ADHD medications increased in Scandinavia from 2010-2020, and the increase was highest in Sweden (16 to 35/1,000) compared to Norway (19 to 22/1,000) and Denmark (16 to 22/1,000). A rise in lisdexamfetamine use in all three countries was the main contributor to this finding, but unlike Norway and Denmark, Sweden also experienced a rise in methylphenidate use.
The Swedish predominance in use of antidepressants, hypnotics and ADHD medications compared to Denmark and Norway applied to both sexes and all age groups.

Conclusions: Treatment with antidepressants, hypnotics and ADHD medications is more common for Swedish youths compared to Norwegian and Danish peers. Further studies should investigate the causes for these Scandinavian differences.