Summary
Marked differences in the utilisation of psychotropic drugs between the three major urban areas in Sweden were recorded from four sources of information: drug supplies from wholesalers to pharmacies, drug supplies to hospitals for in-patient use, drugs sold on prescription for out-patient use, and out-patient consultation and drug prescribing as recorded by physicians.
The total sales of psychotropics in the counties of Gothenburg (110,8 defined daily doses per 1000 inhabitants per day) and Malmö (102,1) were much higher than in the county of Stockholm (73,4), with about 25% of the difference being accounted for by diazepam. Differences in the total sales of psychotropics were not explained by any differences in hospital sales, which amounted to about 10% in all counties. Prescription sales differed due to the higher average number of DDD (defined daily doses) per prescription in Gothenburg and Malmö than in Stockholm (total psychotropics 8 and 15%, respectively), and especially because of the higher number of prescriptions per inhabitant (about 40 and 30–35%, respectively).
There was no substantial difference in the pattern of diagnoses between areas, but there was a noticeable difference with regard to prescriber category, as psychiatrists accounted for more of the prescriptions in Stockholm than in Gothenburg and Malmö.
The results raise questions about over- and under-treatment of mental disorders and about abuse of drugs. In order to explain the geographical differences in psychotropic drug sales morbidity patterns and prescribing practices should be further explored.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ideström C-M (1972) Kliniska synpunkter på konsumtionen av ataraktika och sedativa (Clinical aspects on the consumption of ataractics and sedatives) Läkartidningen 69: 1371–1372
Editorial (1973) Kraftåtgärder behövs mot sömnmedlen (Firm actions against hypnotics needed) Läkartidningen 70: 941
Anonymous (1972) Missbruk av sömnmedel och lugnande medel (Abuse of hypnotics and sedatives) Läkartidningen 69 [Suppl I]: 95
Anonymous (1975) Förskrivning av lugnande medel och sömnmedel (Prescribing of sedatives and hypnotics) Läkartidningen 72: 1090
Grimsson A, Idänpään-Heikkilä J, Lunde PKM, Olofsson O, Westerholm B (1979) The utilization of psychotropic drugs in Finland, Iceland, Norway and Sweden. In: Bergman U, Grimsson A, Wahba AHW, Westerholm B (eds) Studies in drug utilization. WHO Regional Publications. European Series. Copenhagen 8: 163–173
National Corporation of Swedish Pharmacies (Apoteksbolaget) Svensk läkemedelsstatistik 1981 (Swedish Drug Statistics 1981) Stockholm, 1982
Kaij L, Melander A, Stenber P, Widell E (1983) Bruk och missbruk av lugnande medel — information påverkar förskrivningen (Use and abuse of sedatives — information influences prescribing) Läkartidningen 80: 1062–1063
Melander A, Stenberg P (1986) Anxiolytic-hypnotic drugs in out-patient care: pronounced reduction of use, misuse and suicide following prescription surveillance and information. Acta Pharmacol Toxicol [Suppl] 5: 1252 (abstract)
Wessling A (1987) Continuous recording of drug prescriptions in Sweden 1974–1983. Methods and examples of utilization of data. Eur J Clin Pharmacol 33: 7–13
Agenäs I, Jacobsson M, Kristoferson K (1980) Diagnose-Receptundersökningen. Svensk Farmacevtisk Tidskrift (English summary) 84: 321–333
Nordic Statistics on Medicines 1975–1977, parts I–II (1979) Statistical Reports of the Nordic Countries no. 35, 36. Nordic Council on Medicines. Helsinki and Oslo
Bergman U (1978) Utilization of antidiabetic drugs in the island of Gotland, Sweden. Agreement between wholesale figures and prescription data. Eur J Clin Pharmacol 14: 213–220
Stika L (1984) Patterns in drug utilization — national and international aspects: antidiabetic drugs. Acta Med Scand 683 [Suppl]: 53–57
Baksaas I (1978) Drug treatment in hypertension, with special emphasis on the relationship between prescribed and defined daily doses. Medd Norsk Farm Selsk 40: 69–84
Isacson D, Smedby B (1988) Patterns of psychotropic drug use in a Swedish community. Scand J Prim Health Care 6: 51–58
Holmberg K, Kristoferson K (1989) Förskrivningsstudie i sydvästra Stor-Stockholm (Prescription study in Stockholm) Svensk Farmacevtisk Tidskrift 93: 10–15
Griffiths RR, McLeod DR, Bigelow GE, Liebson IA, Roache JD (1984) Relative abuse liability of diazepam and oxazepam: Behavioural and subjective dose effects. Psychopharmacology 84: 147–154
Bergman U, Griffiths RR (1986) Relative abuse of diazepam and oxazepam: prescription forgeries and theft/loss reports in Sweden. Drug Alc Depend 16: 293–301
Boëthius G, Westerholm B (1977) Purchases of hypnotics, sedatives and minor tranquillisers among 2566 individuals in the county of Jämtland, Sweden — a 6 years follow-up. Acta Psychiat Scand 56: 147–159
Balter MB, Levine J, Manheimer DI (1974) Cross-national study of the extent of antianxiety/sedative drug use. N Engl J Med 290: 769–774
Balter MB, Manheimer DI, Mellinger GD, Uhlenhuth EH (1984) A cross-national comparison of antianxiety/sedative drug use. Curr Med Res Opin 8 [Suppl 4]: 5–18
Pharmacological treatment of anxiety (1988) Workshop. Drug Information Committee, National Board of Health and Welfare, Sweden
Treatment of sleep (1988) Workshop. Drug Information Committee, National Board of Health and Welfare, Sweden
Levnadsförhållanden 1975–1983 Rapport 42 (Living conditions 1975–1983 Report 42) Sveriges Officiella Statistik. Statistiska Centralbyrån, Stockholm (1985)
Hälsorådet i Göteborg (1989) Samhällsmedicinska expertrådet. Folkhälsorapport 2. Göteborg
Brodin HFT (1987) Regional variations in pharmaceutical consumption in Sweden. Linköping Studies in Arts and Science. Linköping University, Linköping, Sweden
National Corporation of Swedish Pharmacies (1989) (Apoteksbolaget) Svensk läkemedelsstatistik 1988 (Swedish Drug Statistics 1988) Stockholm
Haugen O, Waaler HT, Hjort PF (1978) Legemiddelforbruket i fylkene — store forskjeller, små forklaringer. (Drug consumption in the Norwegian counties — large differences, few explanations. In Norwegian) The Norwegian Research Council for Science and Humanities. Unit for Health Services Research, report 1, Oslo
Bjørndal A (1983) Gagn eller ugagn, Forbruk av psykofarmaka i Norge. The Norwegian Research Council for Science and Humanities. Unit for Health Services Research, report 4, Oslo
Bjørndal A, Fugelli P (1989) Can regional differences in consumption of tranquillisers and hypnotics be explained by variation in general practitioners' threshold of prescribing? A methodological study. Scand J Prim Health Care 7: 67–71
WHO-Drug Utilization Research Group (1986) Therapeutic traditions in Northern Ireland, Norway and Sweden: I. Diabetes. Eur J Clin Pharmacol 30: 513–519
WHO-Drug Utilization Research Group (1986) Therapeutic traditions in Northern Ireland, Norway and Sweden: II. Hypertension. Eur J Clin Pharmacol 30: 521–525
Strom BL, Morse ML (1988) Use of computerized databases to survey drug utilization in relation to diagnoses. Acta Med Scand [Suppl] 721: 13–20
Bergman U, Lee D (1989) Current approaches to measurement of drug use and abuse in Sweden. In: Fischman MW, Mello NK (eds) Testing for abuse liability of drugs in humans. National Institute on Drug Abuse Research Monograph Series 92: pp 267–286
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wessling, A., Bergman, U. & Westerholm, B. On the differences in psychotropic drug use between the three major urban areas in Sweden. Eur J Clin Pharmacol 40, 495–500 (1991). https://doi.org/10.1007/BF00315229
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00315229