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The number of new prescriptions for antidepressants in England are now lower than they were before the COVID-19 pandemic, according to the results of a study of primary care dispensing between 2019 and 2024.
The study, published in Nature Health on 15 June 2026, is described by the authors as “the most comprehensive analysis to date of medication use in English primary care”, where they analysed NHS prescribing data from 52.6 million patients and 5.8 billion dispensed medications.
“[The study findings] highlight both the [COVID-19] pandemic’s disruption of clinical pathways and potential inequities in medication use, demonstrating the value of medicines intelligence for monitoring and addressing health disparities,” the authors added.
The researchers found an ongoing decline in central nervous system (CNS) medications, including analgesics and antidepressants, across the study period. They also observed that the incident rate of CNS medicines was 4.1 per 1,000 person-months in February 2024 — down from 6.0 per 1,000 person-months in February 2020.
The findings could “signify undertreatment but may also reflect health campaigns promoting a shift towards psychological therapies”, the authors suggested.
Despite the overall decline, the study results showed that in 2024, the antidepressant sertraline was the most common medication among men and women in their 20s and 30s. Additionally, in that age group, twice as many women as men were dispensed a sertraline prescription, with 4.4 million prescriptions dispensed to women, compared with 2.2 million prescriptions dispensed to men, the study results revealed.
The analysis, which looked at medication type by BNF chapter, also showed large differences in dispensing patterns across different demographics, with areas of greater deprivation having higher rates of medication dispensing than in less deprived areas.
The researchers found that in 2024 in the most deprived quintile, according to the Index of Multiple Deprivation, one million medications were dispensed to individuals aged 27 years, while in the least deprived quintile, this number of medications dispensed was not reached until the age of 42 years.
In addition, researchers found that more deprived areas have a higher proportion of medicines dispensed for mental health conditions and pain.
For most BNF chapters, the highest rates of medication use were among Bangladeshi and Pakistani ethnic groups, and was lowest for patients in the Chinese ethnic group, the study results highlighted. They also showed that people from Bangladeshi and Pakistani ethnic groups had higher levels of polypharmacy earlier in life compared with others.
“While age, sex, ethnicity and deprivation are often studied separately, our results suggest that their combined impact (intersectionality) must be addressed together,” the authors wrote.
“Tackling these compounded inequalities remains a major challenge for the NHS and similar health systems worldwide.”
Mahendra Patel, chair of the Royal College of Pharmacy English National Pharmacy Advisory Council, commented: “This research demonstrates the value of linking medicines data with wider health information to better understand population health and health inequalities.
“By looking at patterns of medicine use across diverse communities, healthcare professionals can identify where additional support may be needed, better understand the lasting impact of disruptions to care and help ensure services are planned around the needs of patients.
“While this research doesn’t explain why these differences exist, it provides valuable evidence to inform future research. The findings can also help policymakers identify where healthcare resources and support may be needed most to support more equitable access to care.”
The authors have put the data from their study into a dashboard, which can be used to “help target populations with unmet treatment needs or to make large-scale public health shifts addressing emerging disease trends”.
