Long-term use of antidepressants in Australia has increased over the past decade, with the most significant rise among young people aged 10 to 24. This is according to a new study by researchers at the University of South Australia (UniSA), who examined data from the Pharmaceutical Benefits Scheme covering more than 300,000 users between 2014 and 2023.
The study, published in the Pharmacoepidemiology and Drug Safety Journal, found that nearly half of young people prescribed antidepressants remained on them for more than a year. Many continued treatment beyond two years. The trend was seen across all age groups but was most pronounced among younger Australians.
Lead author Dr Lasantha Ranwala noted: "Not only are more people taking antidepressants, but once they start, they are staying on them for longer." He added that this pattern is particularly concerning for younger patients because clinical guidelines typically recommend psychological therapies as the first treatment option.
Between 2014 and 2022, long-term antidepressant use across the population rose from 66 to almost 85 users per 1,000 people before stabilizing slightly in 2023. Women consistently had higher rates of use compared to men during this period.
Dr Ranwala explained some risks associated with extended use: "While antidepressants play a role in managing moderate to severe depression, prolonged use can increase the risk of side effects and make withdrawal more difficult." He also said: "Withdrawal symptoms are often misinterpreted as a return of the underlying condition, which can further extend treatment, exacerbating the problem."
The research showed little progress in reducing long-term usage. The proportion of long-term users prescribed lower doses stayed about the same over ten years—17.9% in 2014 versus 17.8% in 2023.
Co-author Professor Libby Roughead stated: "This lack of movement suggests that deprescribing strategies are not being routinely implemented in clinical practice." She added: "Given the increase in long-term use, especially among young people, this is an area that requires urgent attention."
Researchers identified several factors contributing to these trends. These include increased mental health issues among youth, rising psychological distress overall, impacts from the COVID-19 pandemic, and limited access to psychological therapies.
The authors called for changes to ensure appropriate prescribing practices and better support for patients wishing to stop medication when it is no longer needed. Prof Roughead said: "Australia needs a stronger framework for safely tapering antidepressants, along with better access to psychological care."
Associate Professor Andrew Andrade suggested that new technologies could help clinicians identify when deprescribing is suitable. He said: "Clinicians need stronger support systems to safely deprescribe antidepressants." He also noted: "Smart technologies can help identify patients who are good candidates for tapering, coordinate timely access to non-pharmacological treatments, and provide clear, step-by-step guidance to clinicians and patients throughout the slow dose-reduction process."
