PURPOSE: The COVID-19 pandemic had detrimental effects on the mental health of populations, with differing influences on different demographic groups. Varying national countermeasures to the pandemic may have further impacted these effects. This study aimed to explore the effects of the pandemic on dispensed volumes of antidepressants in outpatient settings in different regions of Europe and to assess potential age- and sex-related differences of its impact on incidence of antidepressant dispensing. METHODS: We used descriptive and interrupted time series analyses of pharmacy dispensing data on volumes. For six regions, we analysed volume and incident use stratified by age and sex. RESULTS: During the pandemic, the preexisting long-term trend in unstratified dispensed volumes significantly increased only in Slovenia and Germany and weakened in Scotland and Wales (estimated changes in slope + 0.16, + 0.10, - 0.23, and - 0.68 defined daily doses per thousand inhabitants per day, respectively, for each month). The stratified quarterly analysis revealed the greatest relative increase in females aged 0-17 (+ 64% in Sweden to + 167% in Croatia in the last quarter of 2022 compared with the last quarter of 2019). Both rate of change and difference between sexes were lower in higher age groups. Incidence increased most steeply in females aged 0-17, where the estimated pandemic-related increase explained 11% (Sweden) to 55% (Lombardy) of new patients receiving antidepressants. CONCLUSION: Our findings indicate the need to develop targeted mental health supporting measures to increase resilience, especially in young people, and mitigate the impact of potential future public health crises.

AOK Research Institute Berlin Germany

College of Pharmacy Al Kitab University Kirkuk Iraq

Department of Public Health Pharmacy and Management School of Pharmacy Sefako Makgatho Health Sciences University Pretoria South Africa

Epidemiology and Preventive Pharmacology Service Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy

Faculty of Medicine in Hradec Králové Department of Medical Biophysics Charles University Hradec Králové Czech Republic

Health Insurance Institute Ljubljana Slovenia

INVEST Research Centre University of Turku Turku Finland

IRCCS MultiMedica Sesto San Giovanni Milan Italy

Pharmacoepidemiology and Social Pharmacy Department of Pharmacy Uppsala University Uppsala Sweden

Pharmacy Center Department of Medicine Vilnius University Vilnius Lithuania

School of Public Health and Community Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

State Institute for Drug Control Prague Czech Republic

Strathclyde Institute of Pharmacy and Biomedical Sciences University of Strathclyde Glasgow UK

Teaching Institute of Public Health Dr Andrija Stampar Zagreb Croatia

The Social Insurance Institution of Finland Helsinki Finland

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