The number of newly dispensed anxiolytic and antidepressant drugs during the first COVID-19 lockdown period in the Netherlands: Sex- and age-specific trends

Abstract

Background The COVID-19 pandemic disrupted access to healthcare and affected mental health. How these changes translated into the initiation of psychotropic treatment remains unclear. Methods This study analyzed community-pharmacy dispensing data from the Dutch Foundation for Pharmaceutical Statistics (SFK; 96% population coverage) to quantify first-time dispensing's of anxiolytics and antidepressants in weeks 1-26 of 2019 and 2020. Data were stratified by sex (male, female) and age (children 0-9 years, adolescents 10-19, adults 20-64, elderly ≥65). Three periods were evaluated: pre-lockdown (weeks 1-11), first lockdown (weeks 12-19; 15 March-11 May 2020), and post-lockdown (weeks 20-26). Repeated measures GLM with Bonferroni correction assessed within-year changes; paired t-tests compared 2019 with 2020 weekly counts. Results First time dispensings declined in 2020 versus 2019 for both anxiolytics (192,547 vs 205,612) and antidepressants (128,205 vs 141,943; both p < 0.001). Declines concentrated during lockdown. For anxiolytics, reductions were most pronounced in children and adolescents (both p < 0.001); adult males also showed a lockdown-period decrease (p = 0.016), whereas the elderly showed no significant change. For antidepressants, adolescents, adults and the elderly exhibited significant lockdown-period reductions (p < 0.0167). In both years, females received more first-time prescriptions than males (p < 0.001), but initiation decreased for both sexes during lockdown. Conclusions Initiation of anxiolytic and antidepressant therapy fell during the first Dutch lockdown, most likely reflecting disrupted healthcare access and deferred care, rather than reduced need. Therefore, safeguards to preserve care initiation are warranted during future pandemics and associated lockdown periods.