(317) Psychotropic medicine use in the German National Cohort (NAKO) baseline

Background: Psychotropic drug use in Germany has increased in the past 20 years. However, there is a lack of studies that take into account frequency of intake and type of prescription.

Objectives: To assess and describe psychotropic medicine use and psychotropic polypharmacy in the German National Cohort (NAKO) baseline.

Methods: We included persons participating in the baseline examination (2014-2019) of the German National Cohort study (NAKO) (N=204,212; 50.4% female). Medication use was assessed by computer-assisted, face-to-face interviews. Participants were asked to bring packages of the medications they used in the past seven days. Based on the pharmaceutical identification number (PZN) and a database-supported identification system detailed information (e.g. ATC code, strength) was recorded for each medication. In the interview, information was collected for each medication regarding the number of tablets per day, the duration of use, the frequency of use (regularly or as needed) and whether it was prescribed by a physician. We calculated the proportions of participants using psychotropic medications (ATC-codes N03, N05A, N05B, N05C, N06A, N06B, N06C) stratified by sex, age and income group. For those using psychotropic medications, we assessed the frequency of intake (regularly vs. as needed) as well as the number and combinations of psychotropic medicines they used.

Results: Overall, 17,303 out of 204,212 participants used psychotropic medicines. Use of any psychotropic medication was reported by 10.8% [95%CI 10.6;10.9] of women and 6.1% [6.0%;6.3%] of men. Most psychotropic medications were prescribed by a physician and taken regularly by the participants. Antidepressants were the most commonly used medicine. In both men and women, the proportion of users increased with age. In the analyses, participants in the 60- to 69-years age group had the highest proportion of users of psychotropic drugs. A social gradient in psychotropic medication use could also be identified: more participants at risk of poverty reported regular or as needed use of psychotropic medications than participants in higher income groups (13.5% [13.1%;13.9%] in the lowest income group versus 6.7% [6.5%;6.8%] in the highest income group). Psychotropic polypharmacy (i.e. taking more than two psychotropic drugs) was reported by 2.4% [2.3%;2.5%] of women and 1.5% [1.4%;1.6%] of men.

Conclusions: Psychotropic drug use was reported more frequently by women and participants in the lowest income group. However, it should be noted that the NAKO study is not representative for the German population. Thus, our findings should be confirmed in population representative samples.