Ongoing initiatives within the Scottish National Health Service to affect the prescribing of selective serotonin reuptake inhibitors and their influence

Brian Godman, Amanj Kurdi, Holly McCabe, Chris F Johnson, Corrado Barbui, Sean MacBride-Stewart, Simon Hurding, Axel Leporowski, Marion Bennie, Alec Morton

Research output: Contribution to journalArticle

1 Citation (Scopus)


Aim: Increasing use of selective serotonin-reuptake inhibitors (SSRIs) in Scotland, coupled with safety concerns with some SSRIs, and the increasing availability of generic SSRIs, have resulted in multiple initiatives to improve the quality and efficiency of their prescribing in Scotland. Our aim is to assess their influence to provide future direction. Materials & methods: The prescription costs analysis database was used to document utilization and expenditure on SSRIs between 2001 and 2017 alongside documenting the initiatives. Results: Multiple interventions over the years increased international nonproprietary name prescribing up to 99.9% lowering overall costs. This, coupled with initiatives to limit escitalopram prescribing due to concerns with its value, resulted in a 73.7% reduction in SSRI expenditure between 2001 and 2017 despite a 2.34-fold increase in utilization. Safety warnings resulted in a significant reduction in the prescribing of paroxetine, citalopram and escitalopram alongside a significant increase in sertraline Conclusion: Multiple initiatives have increased the quality and efficiency of SSRI prescribing in Scotland providing direction to others.

Original languageEnglish
Pages (from-to)535-547
Number of pages13
JournalJournal of Comparative Effectiveness Research
Issue number7
Early online date26 Apr 2019
Publication statusPublished - 1 May 2019



  • SSRIs
  • Scottish NHS
  • expenditure
  • drug utlisation
  • generics
  • healthcare reform

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