State of anxiety: Covid sparks rise in use of anti-depressants

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More than 170 million anti-depressant drug tablets were dispensed in the first nine months of last year, representing an increase of seven million compared to the same period in 2019.

The figures reveal a surge in patients requiring medication for depression, stress and anxiety during the pandemic.

GPs warn they have been unable to refer patients with anxiety and depression to psychology services since the start of the pandemic because they have been redeployed to help with Covid-19 testing.

The new figures relate to prescriptions written under the medical card scheme, the drug payment scheme and the long-term illness scheme.

In 2019, 167,477,999 tablets were dispensed across all three schemes from January to September. Last year that figure jumped to 174,473,962.

The information, obtained from the Health Service Executive’s Primary Care Reimbursement Service (PCRS), the body in the health service that processes drug payments, shows an increase in dispensing across more than half of all drugs available to treat depression.

The data relates to the three main public drug schemes – the General Medical Services, the Drugs Payment Scheme, and the Long-Term Illness Scheme.

Combined, these schemes cover close to 70pc of the population. The figures for the overall population are likely to be higher as the data provided does not include items dispensed outside of community drug schemes where the prescription has been paid for privately.

Monaghan GP Illona Duffy said GPs have seen a surge in patients who are presenting with anxiety and mild depression since last March. “Anxiety levels are massive,” she told the Irish Independent.

“Due to all the Covid restrictions, people don’t have the same emotional supports they may have had. We see a lot of people who are living alone, who are vulnerable, who can’t get to meet and can’t get to see people and that’s adding to anxiety and depression.

“Covid? Yes we want people to be worried about it because it’s serious, but that has fed into other anxiety.”

In figures released to the Irish Independent under Freedom of Information legislation, 24 out of 44 drugs available under the general medical services scheme have seen an increase in the number of tablets dispensed.

Most notably, there was a 56pc increase in the use of Milnacipran and a 43pc increase in dispensing figures for Vortioxetine, which is used for treating major depressive episodes.

Under the Drug Purchase Scheme, dispensing increases were recorded in 27 out of 45 drugs. There has a been a 59pc increase in the use of Vortioxetine.

Increases were recorded in 23 out of 41 drugs available under the long-term illness scheme, with a 77pc increase in the Nitrazepam tablets dispensed when compared with last year.

“We (GPs) are trying our best, but we don’t have the skillset and often it’s then down to prescribing medication,” said Ms Duffy.

“We have no psychology services. It’s a scandal that people with this skillset have been redeployed to testing when they are so badly needed. We are finding that children and adults have no access to psychology and with underlying disorders, where we know first- line treatment should be psychological interventions, it’s just not happening.

“Here in Cavan/Monaghan we have had no primary care psychology service since the outbreak of Covid. In the old days, if you had somebody who had anxiety, rather than jumping straight in with medication, or if they had mild depression, you would be looking at other things, like cognitive behavioural therapy or some talk therapy.”

Figures show that in 2020, the largest number of tablets issued across all three schemes were for the drug Zopiclone, of which almost 14.5 million were dispensed.

In 2019, the figure was just over 14.2m.

It falls under the Z-drug category, which are a class of drugs often used to treat insomnia.

Z-drugs – Zopiclone and Zolpidem – reduce the length of time it takes people to fall asleep and extend that period of sleep.

“These Z-drugs have a huge addictive potential,” said Ms Duffy. “There is strong guidance in terms of prescribing Zopiclone. In our practice we only prescribe wh ere absolutely necessary and for no longer than a fortnight.

“Sleep is a big problem at the minute. People are not as physically active as they might have been. They have had changes in routine.

” They are at home, they may be on monitors and screens for longer. People are watching movies on their phones late at night and all of this disrupts sleep.”

In a statement, the HSE said: “Primary Care Psychology Services redeployed some staff on a part-time and demand-led basis to support the development and roll-out of essential Covid-19 services from March 2020, alongside other Primary Care Services.

“This level of redeployment ended in October 2020.”

Source: Irish News