Impact of the COVID-19 pandemic on psychotropic medication uptake: time-series analysis of a population-wide cohort

Aideen Maguire, Lisa Kent, Siobhan O'Neill, Denise O'Hagan, Dermot O'Reilly

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BACKGROUND: The COVID-19 pandemic and associated lockdowns were predicted to have a major impact on mental health, however current studies have produced contradictory findings with limited longitudinal data.

AIMS: Nine years of linked, individual-level administrative data were used to examine changes in psychotropic medication uptake before and during the pandemic.

METHOD: Medication data from a population-wide prescribing database were linked to demographic and socioeconomic indicators from healthcare registration records ( n = 1 801 860). Monthly prescription uptake was split (pre-restrictions: January 2012 to February 2020 and during restrictions: March to October 2020). Auto regressive integrated moving average (ARIMA) models were trained in R taking into consideration trends and seasonal effects. Forecast ('expected') monthly values were compared with 'actual' values, stratified by demographic factors.

RESULTS: Over the study period 38.5% of the study population were in receipt of ≥1 psychotropic medication. Uptake of these medications have been following a strong upward trend since January 2012. In March 2020 uptake of all medications increased beyond expected values, returning to expected trends from May 2020 for antidepressants, anxiolytics and antipsychotics. In the 8 months during restrictions uptake of hypnotic medication was 12% higher than expected among those <18 years, and anxiolytic medication higher than expected in those >65 years.

CONCLUSIONS: Results suggest an initial 'stockpiling' of medications in March 2020 before trends mostly returned to expected levels. The anticipated tsunami of mental ill health is not yet manifest in psychotropic medication uptake. There are indications of increased anxiety and sleep difficulties in some subgroups, although these conditions may resolve as we emerge from the pandemic without need for psychiatric intervention.

Original languageEnglish
Pages (from-to)748-757
Number of pages10
JournalBritish Journal of Psychiatry
Issue number6
Early online date15 Aug 2022
Publication statusPublished (in print/issue) - 31 Dec 2022

Bibliographical note

Funding Information:
The authors would like to acknowledge the help provided by the staff of the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO). The HBS is funded by the BSO and the Department of Health, Social Services and Public Safety for Northern Ireland (DHSSPSNI). The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the author and do not necessarily represent those of the BSO.

Funding Information:
This work was supported by both the UKRI's ADRC-NI (ES/S00744X/1) and the Northern Ireland Public Health Agency's HSC RD (COM/5625/20).

Publisher Copyright:
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.


  • mental health
  • psychotropic medications
  • data linkage
  • COVID-19
  • cohort
  • COVID-19/epidemiology
  • Pandemics
  • Humans
  • Psychotropic Drugs/therapeutic use
  • Communicable Disease Control
  • Research Design
  • Cohort Studies


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