Much lower use of antidepressants in Norway compared to the rest of Europe
“We have a more realistic view of what antidepressant drugs can actually do today”, says researcher.
In the guidelines for treatment of depression in Norway and in Europe, therapy is recommended as the first choice for mild to moderate depression.
In more serious cases, antidepressants may be recommended by a patient's GP, says Anneli B. Hansen. Hansen is a physician as well as a researcher at NORCE Norwegian Research Centre.
In a recent study, she has looked at 50 000 patients who were given the diagnosis of depression from their GPs in 2015. 80 per cent of antidepressants in Norway are prescribed by GPs.
The data come from various Norwegian health registries and show that one in three patients who are diagnosed with depression in Norway are prescribed antidepressants.
New knowledge has changed attitudes
When Hansen and colleagues compare their data to similar data from other European countries, the differences are stark.
Antidrepression prescription rates from other European countries vary between 45-75 per cent according to varoius studies.
Patients in Norway in other words have a considerably lower chance of being prescribed drugs for depression compared to patients in other European countries.
Hansen believes that new knowledge about treatments of depression have changed the attitudes to medicating the problem.
“When the new antidepressants came in the 1990s, there was great optimism. Today we have a more realistic view of what these drugs can actually do. This is why they are no longer the first line of treatment”, she says.
Women with lower education
The researchers also found some differences within the Norwegian population they studied regarding who gets prescribed antidepressants or not.
It appears that women with lower levels of education are more often prescribed antidepressants. Women with high levels of education are less likely to be given drugs as treatment.
There are also age differences – the women who are prescribed antidepressants are more often in their 20s or their 70s.
In total however, more men than women are prescribed drugs for their depressions – 33 per cent versus 30 per cent.
The study has only looked at data from registries, no patients have been interviewed. Hansen and her colleagues however assume that those who have not been prescribed drugs have been given other forms of treatment, namely therapy.
“Earlier research has shown us that women are more positive to therapy compared to men. That may explain the gender differences that we have found”, Hansen says to sciencenorway.no.
“It may also be that when a man finally goes to see his GP about this, the depression has lasted longer. The disease may be more serious. This might make it more natural for the GP to also offer medications, in addition to therapy”, she says.
Steinar Madsen is a physician and medical director at The Norwegian Medicines Agency. He has read the study and writes to sciencnorway.no in an email that he finds the differences in treatment of depression that the researchers have found to be very small.
“The differences are surprisingly small between the different levels of education. Particularly when you compare radically different levels like primary school and university”.
Madsen believes that this is an indication of a Norwegian health service with very small differences when it comes to the treatment given.
Hansen, Anneli Borge, General practitioners’ drug treatment for depression by patients’ educational level: registry-based study, British Journal of General Practice Open, November 2020