(220) Common Mental Health Diagnoses Arising from or Coinciding with Menopausal Transition and Prescribing of SSRIs/SNRIs and Other Psychotropic Medications

Background: Men and women are at an elevated risk of experiencing common mental health diagnoses (CMHDs: depression or anxiety) in midlife (age 45-54 years). It is unknown how many men and women receive pharmacological treatment for CMHDs diagnosed in midlife and which medicines are most prescribed after a diagnosis of CMHD. Lastly, prescribing rates of serotonin reuptake inhibitors (SSRIs) /selective norepinephrine reuptake inhibitors (SNRIs) to men and women in this age group have not been estimated in the UK.

Objectives: This study aimed to measure the rate of CMHDs in women going through menopausal transition in comparison with men of the same age, measure the type and proportion of psychotropic medications prescribed for CMHDs, and estimate incidence of prescribing SSRIs/SNRIs.

Methods: We conducted a drug utilisation study. All persons aged 45-54 years-old registered with an IMRD-UK practice between 1 Jan 2010 and 11 Nov 2021 were included. Incidence rates (IR) of CMHDs per 100 person-years at risk (PYAR) for men and women were estimated. Incidence rate ratios (IRR) with 95% confidence intervals (CIs) were estimated by using men as the reference group. We measured the first prescriptions for psychotropic medications within 12 months of CMHD diagnosis. We measured the annual prescribing of SSRIs/SNRIs in men and women with CMHDs. IRs of SSRIs/SNRIs prescribing were reported per 100 PYAR.

Results: In 2021, rates of anxiety disorders were 1.68 per 100 PYAR in women aged 45-54 years-old compared with 0.91 per 100 PYAR in men, with an IRR of 1.85 (95% CI: 1.72-1.97). The rate of depressive disorders was 1.69 per 100 PYAR in women aged 45-54 years-old compared with 1.20 in men, with an IRR of 1.44 (95% CI: 1.35 – 1.53). SSRIs/SNRIs were the most prescribed medications within 12 months after the diagnosis of CMHD in both women (36.59%) and men (37.30%) aged 45-54 years-old. The IR of prescribed SSRIs/SNRIs to men increased from 11.89 per 100 PYAR in 2010 to 22.57 per 100 PYAR in 2021. The IR of prescribed SSRIs/SNRIs to women increased from 14.57 per 100 PYAR in 2010 to 22.31 per 100 PYAR in 2021.

Conclusions: Women aged 45-54 years experienced more CMHDs compared to men, which coincides with menopausal transition. SSRIs/SNRIs were the most commonly prescribed medications for CMHDs in midlife in men and women. Although women were diagnosed with CMHDs at higher rates, the sex-specific prescribing rates of SSRIs/SNRIs were similar between sexes.