Drug Utilization Research / Trends and comparisons

5A-06 - DARWIN EU® - Antipsychotic prescribing in the general population in Europe: a descriptive analysis of trends and patient characteristics

Tuesday, August 26, 2025

9:45 AM - 10:00 AM ET

Location: 208AB

Presenting Author(s)

WW

Wanning Wang

Health Data Sciences, Centre for Statistics in Medicine, University of Oxford, United Kingdom

PDF Slides

Co-Author(s)

MD

Mike Du

Health Data Sciences, Centre for Statistics in Medicine, University of Oxford, United Kingdom
EB

Edward Burn

Health Data Sciences, Centre for Statistics in Medicine, University of Oxford, United Kingdom
TD

Talita Duarte Salles

Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain, Spain
AP

Anna Palomar-Cros, PhD

Epidemiologist
Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain, Spain
Agustina Giuliodori, PhD

Data Scientist
Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
Barcelona, Catalonia, Spain
Katia Verhamme, MD, PhD

Associate Professor of Use and Analysis of Observational Data
Erasmus University Rotterdam (EUR) - Erasmus Medical Center (MC)
Rotterdam, Zuid-Holland, Netherlands
DV

Dina Vojinovic

IQVIA, Real World Solutions, Amsterdam, The Netherlands, Netherlands
GJ

Gargi Jadhav

IQVIA, Real World Solutions, London, United Kingdom, United Kingdom
EB

Elvira Bräuner

Data Analytics Center, Danish Medicines Agency, Denmark
AJ

Antea Jezidžić

Department for Data Science and Analytics, Division for Medical Informatics and Biostatistics, Croatian Institute of Public Health, Croatia
EB

Emanuel Brađašević

Division for Medical Informatics and Biostatistics, Croatian Institute of Public Health, Croatia
Daniel Prieto-Alhambra

Health Data Sciences, Centre for Statistics in Medicine, University of Oxford, United Kingdom
MP

Marta Pineda-Moncusi

Health Data Sciences, Centre for Statistics in Medicine, University of Oxford, United Kingdom

Background: Antipsychotics licensed for the management of schizophrenia and bipolar disorder, are also prescribed to manage behavioural and psychological symptoms of dementia in older populations. Use of antipsychotics has been associated with adverse drug reactions, particularly among the elderly.

Objectives: To describe patient characteristics and incidence rates of use of common antipsychotics.

Methods: A new user cohort study was conducted using six primary care databases in the DARWIN EU ® initiative and mapped to the OMOP Common Data Model, covering Catalonia, Spain (SIDIAP), Netherlands (IPCI), Denmark (DK-DHR), Germany (IQVIA DA Germany), Belgium (IQVIA LPD Belgium) and Croatia (NAJS). We characterised new users of antipsychotic drugs (ATC: N05A) in the period between 01/01/2013 and 31/12/2023 (or latest date available), with at least 365 days of visibility prior to the date of their first antipsychotic prescription and no prior use of the respective antipsychotic drug/s. Index date was defined as date of first prescription of the antipsychotic of interest. Annual incidence rates (IR) of antipsychotic use per 100,000 person-years with 95% confidence intervals (CI) were estimated and stratified by database, calendar year, and age.

Results: Total new antipsychotic users ranged from 20,223 (Belgium) to 573,433 (Croatia) patients. Across all data sources, the most prescribed antipsychotics were haloperidol, quetiapine, risperidone, sulpiride, and olanzapine. Median age ranged from 53 to 68 years. The most common recorded indications for antipsychotic use were insomnia and other sleep disorders (ranged from 5 to 49% of new users), depression (19 to 52%) and dementia (5 to 22%).

IR ([95% CI] per 100,000 person-years) of antipsychotic use were stable in Netherlands (~400 cases per 100,000 person-years) and Spain (~850), increasing in Germany (2013: 155 [152 - 158] to 2018: 438 [432 - 445]) and Denmark (2013: 250 [243 - 252] to 2023: 312 [308 – 317), and decreasing in Croatia (2016: 2,250 [2,233-2,266] to 2020: 980 [970-990]). In Belgium, incident use decreased from 2015 to 2021 then increased from 2021 to 2023 (2015: 852 [818 - 887], 2021: 576 [551 - 601], 2023: 877 [834 - 921]). Amongst all databases and types of antipsychotics the oldest age group ( ≥85-year-olds) had the highest IRs, followed by the 75 to 84, 65 to 74, and ≤64-year-old age groups. There were increasing trends in IRs among the ≥85 years old age group in Spain, Germany and Denmark.

Conclusions: With large proportions of non-psychosis related indications and higher incidence rates among the elderly, the use of antipsychotics in Europe should be closely monitored.