Analysis of antidepressant use in Republic of Serbia from 2013 to 2015

Introduction: Depression is a chronic mental disorder that causes changes in mood, thoughts, behavior and physical health. According to the World Health Organization (WHO) 350 million people worldwide are said to suffer from this mental disorder. This explains why antidepressants are widely used. Aim: The aim of this study was to analyze the use of antidepressants in Serbia, Norway and Finland from 2013 to 2015. Methods: The data about the use of antidepressants in Serbia, Norway and Finland in 2013, 2014 and 2015 was taken from the Agency for Drugs and Medical Devices of the Republic of Serbia, the sites of Norwegian Institute of Public Health, and Finish Agency for Drugs Fimea. Results: Large number of depressed patients and smaller number of antidepressants used in Serbia compared to Finland and Norway in 2013, 2014 and 2015 can be explained by a different socioeconomic status and different health system in those three countries. Patients in Serbia are underdiagnosed and undertreated due to a failure of the primary care physicians to identify depressed patients, so that those can be treated by a psychiatrist at the secondary health care level. Sertralin is the first-choice medication in Serbia compared to escitalopram in Norway and Finland. Escitalopram has the highest probability of remission of the investigated antidepressants and is the most effective and cost-effective pharmacological treatment strategy for depression in a primary care setting. Conclusion: The consumption of antidepressants in Serbia increased in 2015 compared to 2013, but was still significantly less in Serbia in 2013, 2014 and 2015 compared to Finland and Norway, pharmacotherapeutically developed countries. Medications consumed the most in all 3 countries in 2013, 2014 and 2015 were selective serotonin reuptake inhibitors. Sertraline was the most widely used antidepressant in Serbia in 2015, while escitalopram was mostly used antidepressant in Norway and Finland