Jaanus Harro1,2, Kaire Aadamsoo2, Ott Laius1,3, Ly Rootslane3
1Tartu University Psychiatric Clinic, Tartu, Estonia
2North Estonia Medical Centre Psychiatric Clinic, Tallinn, Estonia
3Estonian State Agency of Medicines, Tartu, Estonia
Since the emergence of modern antipsychotic, antidepressant and anxiolytic drugs in 1950ies the use of psychotropic medicines has profoundly changed psychiatric practice worldwide. While the pivotal role of pharmacotherapy in psychiatry is universal, significant regional differences exist in drug use patterns. The drug regulatory authorities of Estonia, Latvia and Lithuania use the Anatomical Therapeutic Chemical (ATC) classification system and the Defined Daily Dose (DDD) as a measuring unit (see the website of the WHO Collaborating Centre for Drug Statistics Methodology; www.whocc.no) that supports drug use statistics at national level and international comparisons. Herewith we compare the use of ATC psychotropic drugs (N05, psycholeptics) in 2010-2015. During this period the use of antipsychotics, anxiolytics, hypnotics and sedatives, and antidepressants, as expressed in DDD per 1000 inhabitants per day, steadily increased, while the growth in use of anxiolytics stagnated in the more recent years. Antipsychotic use was the largest in Lithuania and the lowest in Estonia. The N05AH group (diazepines, oxazepines, thiazepines and oxepines) was prescribed in Estonia almost at the level of Lithuania, but lower was the prescription of butyrophenones and benzamides. The use on anxiolytics in Lithuania was more than twice of that in Estonia and Latvia; to a large extent this difference was made by prescription of lorazepam while other drugs also contributed. Conversely, the use of hypnotics and sedatives was about three times higher in Estonia than in Latvia or Lithuania, mostly owing to the extensive use of zopiclone in Estonia. Antidepressant use was dominated by the selective serotonin reuptake inhibitors in all three countries, but overall was much lower in Latvia as compared to Lithuania and Estonia. Conclusively, while the health care expenditures in Estonia, Latvia and Lithuania are largely similar, as is the cultural and recent political background of these EU member countries, the extent and the pattern of psychotropic drug use is remarkably variable.