Psychotropic drugs are among the most utilized medications in Europe.

To perform an international comparison of the utilization trends of antidepressants, anxiolytics, hypnotics and sedatives (AHS).

We used data from the Organization for Economic Cooperation and Development (OECD). We used the World Health Organization's Defined Daily Dosage (DDD) per 1000 inhabitants per day (DHD) methodology. We performed a general comparison between 14 European countries and a more detailed comparative analysis between Portugal, Italy, Spain and Germany. These countries were selected according to the following criteria: similar 12-month prevalence of mental health disorders, similar results for negative mental health (SF-36 questionnaire) and similar standardized death rates for suicide.

Portugal had the highest overall utilization of antidepressants and AHS in 2011, amounting to 110.7 DHD, and the highest increase in utilization of AHS (1.8%) from 2003 and 2011. Concerning antidepressants, Portugal had the third highest utilization of these drugs in 2011 (78.3 DHD). Regarding the more detailed comparative analysis, utilization of AHS was still significantly higher in Portugal. Considering antidepressants, Portugal experienced an increasing utilization, which grew by approximately 11.4% from 2003 and 2008. From 2009 onward the utilization increased but at a slower pace.

The very high utilization of these drugs, especially of AHS, is a worrying fact since this might indicate an inadequate treatment choice for anxiety and depressive disorders. Further research is needed to better understand the relationship of these findings with regulations concerning utilization of psychotropic drugs and compliance with best medical practices between distinct European countries.

The authors have not supplied their declaration of competing interest.