# Psychotropic medication consumption before and after onset of COVID-19 pandemic in 91 countries and regions: a time-series analysis

## TL;DR

Psychotropic medication use increased globally after the start of the COVID-19 pandemic, with varying trends across different income-level countries.

## Contribution

This study provides the first comprehensive global analysis of psychotropic medication consumption trends before and after the onset of the COVID-19 pandemic.

## Key findings

- Global psychotropic medication consumption increased from 34.12 to 36.15 DDD/TID between 2020 and 2022.
- High-Income Countries showed a 2.48% annual increase in consumption, while Lower-Middle-Income Countries showed a 1.82% increase.
- 70 out of 91 countries exhibited an increasing trend in psychotropic medication consumption after the pandemic onset.

## Abstract

The availability of psychotropic medications serves as a key indicator of global mental health status, underscoring the critical importance of continued monitoring. However, comprehensive studies assessing the global effect of the COVID-19 pandemic on such trends remain lacking. This study aimed to describe psychotropic consumption trends before and after the onset of the COVID-19 pandemic and investigate the pandemic's short- and long-term effects on psychotropic consumption across 91 countries and regions.

This study used country-level sales data of psychotropic medications between Q1, 2012, and Q2, 2023 of 91 countries and regions from the IQVIA-Multinational Integrated Data Analysis System. Average annual sales trends were estimated and expressed as defined daily dose per 1000 inhabitants per day (DDD/TID) at the overall level and stratified by medication class and country income level. Relative average annual changes were assessed for the periods 2017–2019 and 2020–2022 both overall and within specific medication classes and income groups. The pandemic's short- and long-term effects on psychotropic medication sales were examined through interrupted time series analyses using quarterly data, conducted for each country and at overall level.

Globally, the total consumption of psychotropic medications increased from 34.12 DDD/TID in 2020 to 36.15 DDD/TID in 2022, corresponding to a relative average increase of 2.94% [95% CI 0.97, 4.94] annually. The estimated relative change during 2020–2022 were 1.82% [1.02, 2.64] in Lower-Middle-Income-Countries (LMICs), 6.77% [−0.39, 14.45] in Upper-Middle-Income-Countries (UMICs), and 2.48% [0.72, 4.27] in High-Income-Countries (HICs). Overall psychotropic consumption showed an initial surge in Q1 2020 (level change: 1.94 DDD/TID [1.67, 2.21]), followed by a rapid decline during Q2 2020 (level change: −1.03 [−1.52, −0.54]). Most HICs exhibited a similar pattern. Following the pandemic onset, there was an increasing trend in overall psychotropic consumption (trend change: 0.13 [0.07, 0.19]). 70 of 91 countries showed an increasing slope change.

Psychotropic medication consumption increased globally after the onset of the COVID-19 pandemic. During the pandemic, consumption rates in LMICs and UMICs appeared to slow down, however, patterns of change in psychotropic medication consumption following onset of the pandemic vary on a country level. To address these disparities, strategies for equitable psychotropic medication distribution and enhanced mental health care access in LMICs and UMICs are needed to improve global mental health.

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