England - October to December 2024

Published 6 March 2025

Summary

Antidepressant items and hypnotics and anxiolytics items followed the expected trend during Q3 2024/25.

In Q3 2024/25, CNS stimulants and drugs for ADHD items continued to increase beyond the range of expected values.

In Q3 2024/25, antipsychotics were below the range of expected items based on pre-pandemic prescribing trends.

1. Things you should know

1.1. Scope

This publication provides information exploring how the COVID-19 pandemic has affected the use of medicines used to treat mental health in England. It covers medicines prescribed in England that are then dispensed in the community in England, Scotland, Wales, Isle of Man of the Channel Islands. The publication does not include data on medicines used in hospitals, prisons or prescribed by private doctors.

Further information on the drug groups covered here can be found in the overview and relevant summaries also included in this release.

1.2. Prescribing during the COVID-19 pandemic

We have created a model to help users interpret the impact of the COVID-19 pandemic on prescribing trends.

The number of expected prescription items for each BNF section during this period has been calculated by extrapolating figures for March 2020 to December 2024 according to:

  • the trend in prescription items for each section between April 2015 and February 2020
  • the number of dispensing days that occur in each month
  • the typical differences between each month of the year observed between April 2015 and February 2020
  • the typical differences between each combination of 20 year age band group and gender

A linear regression model has been used to estimate the number of items prescribed, to stay relatively simple and consistent with the model used in previous releases. The model estimates the expected number of items prescribed based on pre-pandemic trends, for each combination of age band and gender. These estimates have then been added together to get an estimate of the total items expected per month, with a 99% prediction interval (PI) calculated.

Prediction interval (PI)

A range calculated based on the uncertainty around the fit of the model. A 99% PI means the new observation is likely to fall within the interval of predicted values 99% of the time.

The data used in this model has been split into groups by patients’ 20 year age band and gender. As age band and gender were included in the model, the model was only fitted to data where age band and gender were both known. This means the charts of predictions made using the model are not based on the same full data used in the rest of this publication. These charts cannot be directly compared to each other or to the quarterly and monthly charts of items prescribed. More information on the methodology behind the model can be found in the background and methodology document

2.1. Antidepressant prescribing

Expected and actual prescribing activity during the COVID-19 Pandemic - BNF 4.3: Antidepressant drugs

Chart
Figure 1 : Antidepressant prescribing
Table
Table 1: Antidepressant prescribing
Year Month Antidepressant prescribed items Antidepressant expected items 99% Prediction interval (Lower) 99% Prediction interval (Upper)
202003 6,718,560 6,477,894 6,094,799 6,860,989
202004 6,405,864 6,181,599 5,799,221 6,563,977
202005 6,175,149 6,341,606 5,959,228 6,723,984
202006 6,396,945 6,442,261 6,062,868 6,821,655
202007 6,704,094 6,537,886 6,156,431 6,919,340
202008 6,081,023 6,334,113 5,946,744 6,721,483
202009 6,579,330 6,469,424 6,089,295 6,849,553
202010 6,733,119 6,679,565 6,299,436 7,059,694
202011 6,516,456 6,473,464 6,088,875 6,858,052
202012 6,995,987 6,737,400 6,358,006 7,116,793
202101 6,645,749 6,597,139 6,212,550 6,981,727
202102 6,273,846 6,260,439 5,880,736 6,640,142
202103 7,053,642 6,940,263 6,543,286 7,337,241
202104 6,823,978 6,505,369 6,113,973 6,896,765
202105 6,528,433 6,665,377 6,273,980 7,056,773
202106 6,945,674 6,766,031 6,377,753 7,154,310
202107 6,943,314 6,861,656 6,471,464 7,251,848
202108 6,645,036 6,657,884 6,261,511 7,054,256
202109 6,970,810 6,793,194 6,404,247 7,182,141
202110 6,688,073 6,864,736 6,473,340 7,256,132
202111 6,966,620 6,935,833 6,547,554 7,324,112
202112 7,285,849 7,061,170 6,672,891 7,449,449
202201 6,931,715 6,920,909 6,527,303 7,314,515
202202 6,496,606 6,584,209 6,195,527 6,972,892
202203 7,356,342 7,264,034 6,857,542 7,670,526
202204 6,870,109 6,829,140 6,426,487 7,231,792
202205 7,171,086 7,127,746 6,727,719 7,527,774
202206 6,986,992 6,812,603 6,388,888 7,236,318
202207 6,943,528 7,046,827 6,645,821 7,447,833
202208 7,154,663 7,120,253 6,720,864 7,519,643
202209 7,124,423 6,978,365 6,575,713 7,381,017
202210 7,056,951 7,188,506 6,785,854 7,591,158
202211 7,240,139 7,259,604 6,860,177 7,659,030
202212 7,221,891 7,384,940 6,985,513 7,784,367
202301 7,274,065 7,244,679 6,839,830 7,649,528
202302 6,703,568 6,907,979 6,508,062 7,307,896
202303 7,669,569 7,587,804 7,169,665 8,005,943
202304 6,869,288 7,014,310 6,582,337 7,446,284
202305 7,337,332 7,312,917 6,896,952 7,728,882
202306 7,452,945 7,413,572 7,000,918 7,826,226
202307 7,271,542 7,370,597 6,956,273 7,784,922
202308 7,437,860 7,444,024 7,031,358 7,856,689
202309 7,288,908 7,440,735 7,027,547 7,853,922
202310 7,420,822 7,512,276 7,096,311 7,928,242
202311 7,500,033 7,583,374 7,170,720 7,996,027
202312 7,430,662 7,570,111 7,151,972 7,988,250
202401 7,709,757 7,707,049 7,294,395 8,119,703
202402 7,238,570 7,370,349 6,954,466 7,786,232
202403 7,366,715 7,634,375 7,199,688 8,069,063
202404 7,604,857 7,615,280 7,187,043 8,043,516
202405 7,796,405 7,775,287 7,347,051 8,203,523
202406 7,257,853 7,598,743 7,165,456 8,032,030
202407 7,908,925 7,832,967 7,403,736 8,262,197
202408 7,601,639 7,767,794 7,339,970 8,195,618
202409 7,468,429 7,625,906 7,194,761 8,057,050
202410 7,943,616 7,974,646 7,546,410 8,402,882
202411 7,602,637 7,907,144 7,479,377 8,334,911
202412 7,797,716 7,893,881 7,460,594 8,327,168

Between March 2020 and December 2024, there were 411 million antidepressants prescribed to identified patients with a known age and gender. This was 622,000 items less than expected based on historical trends. Antidepressant items stayed within the expected range of values over this period.

2.2. Hypnotics and anxiolytics prescribing

Expected and actual prescribing activity during the COVID-19 Pandemic - BNF 4.1: Hypnotics and anxiolytics

Chart
Figure 2 : Hypnotics and anxiolytics prescribing
Table
Table 1: Hypnotics and anxiolytics prescribing
Year Month Hypnotics and anxiolytics prescribed items Hypnotics and anxiolytics expected items 99% Prediction interval (Lower) 99% Prediction interval (Upper)
202003 1,186,543 1,192,641 1,138,854.0 1,246,428
202004 1,172,975 1,108,030 1,054,343.3 1,161,716
202005 1,109,937 1,132,236 1,078,549.3 1,185,922
202006 1,151,653 1,151,225 1,097,958.3 1,204,493
202007 1,195,095 1,166,139 1,112,582.0 1,219,695
202008 1,076,463 1,121,838 1,067,451.1 1,176,225
202009 1,156,591 1,152,889 1,099,518.7 1,206,259
202010 1,179,806 1,186,949 1,133,578.7 1,240,319
202011 1,135,231 1,124,332 1,070,335.3 1,178,328
202012 1,222,616 1,183,058 1,129,790.7 1,236,325
202101 1,153,245 1,148,876 1,094,879.5 1,202,873
202102 1,089,377 1,069,576 1,016,264.9 1,122,886
202103 1,208,596 1,209,596 1,153,860.1 1,265,332
202104 1,142,947 1,091,712 1,036,759.3 1,146,664
202105 1,082,352 1,115,918 1,060,965.3 1,170,870
202106 1,148,170 1,134,908 1,080,392.9 1,189,422
202107 1,152,069 1,149,821 1,095,037.3 1,204,604
202108 1,102,233 1,105,520 1,049,869.1 1,161,171
202109 1,154,988 1,136,571 1,081,962.7 1,191,180
202110 1,104,771 1,137,358 1,082,405.7 1,192,310
202111 1,142,343 1,141,287 1,086,772.5 1,195,802
202112 1,190,042 1,166,740 1,112,225.3 1,221,255
202201 1,130,457 1,132,558 1,077,295.6 1,187,821
202202 1,061,373 1,053,258 998,686.4 1,107,829
202203 1,188,181 1,193,278 1,136,206.5 1,250,350
202204 1,099,384 1,075,394 1,018,861.0 1,131,927
202205 1,136,975 1,132,873 1,076,708.8 1,189,037
202206 1,104,970 1,052,043 992,553.4 1,111,533
202207 1,084,337 1,100,230 1,043,928.0 1,156,531
202208 1,126,230 1,122,475 1,066,400.8 1,178,550
202209 1,124,236 1,086,980 1,030,447.4 1,143,513
202210 1,102,781 1,121,040 1,064,507.4 1,177,573
202211 1,120,619 1,124,969 1,068,889.5 1,181,049
202212 1,109,020 1,150,422 1,094,342.3 1,206,502
202301 1,126,047 1,116,240 1,059,399.2 1,173,082
202302 1,032,918 1,036,940 980,791.1 1,093,089
202303 1,175,188 1,176,960 1,118,253.4 1,235,667
202304 1,037,992 1,025,803 965,153.4 1,086,452
202305 1,101,674 1,083,282 1,024,880.0 1,141,684
202306 1,112,282 1,102,272 1,044,334.9 1,160,209
202307 1,083,953 1,083,912 1,025,740.2 1,142,083
202308 1,115,336 1,106,158 1,048,219.0 1,164,096
202309 1,086,454 1,103,935 1,045,923.6 1,161,947
202310 1,101,343 1,104,722 1,046,320.4 1,163,124
202311 1,103,260 1,108,651 1,050,714.5 1,166,588
202312 1,091,383 1,100,831 1,042,124.0 1,159,538
202401 1,136,326 1,133,196 1,075,258.7 1,191,133
202402 1,061,565 1,053,895 995,504.9 1,112,285
202403 1,068,607 1,094,096 1,033,065.8 1,155,127
202404 1,092,498 1,076,031 1,015,906.5 1,136,156
202405 1,114,411 1,100,237 1,040,112.5 1,160,362
202406 1,032,646 1,052,681 991,847.0 1,113,515
202407 1,120,081 1,100,867 1,040,602.7 1,161,131
202408 1,079,193 1,089,840 1,029,772.9 1,149,907
202409 1,063,141 1,054,344 993,811.4 1,114,877
202410 1,130,053 1,121,678 1,061,552.9 1,181,802
202411 1,073,084 1,092,334 1,032,274.8 1,152,392
202412 1,104,001 1,084,513 1,023,679.4 1,145,347

There were 64.9 million hypnotics and anxiolytics items prescribed to identified patients with a known age and gender between March 2020 and December 2024. This was 214,000 more than the 64.7 million items expected based on historical trends. Hypnotics and anxiolytics items stayed within the expected range of values for this period.

2.4. CNS stimulants and drugs used for ADHD prescribing

Expected and actual prescribing activity during the COVID-19 Pandemic - BNF 4.4: CNS stimulants and drugs used for ADHD

Chart
Figure 4 : CNS stimulants and drugs used for ADHD prescribing
Table
Table 4: CNS stimulants and drugs used for ADHD prescribing
Year Month CNS stimulants and drugs used for ADHD prescribed items CNS stimulants and drugs used for ADHD expected items 99% Prediction interval (Lower) 99% Prediction interval (Upper)
202003 144,880 129,845.1 113,340.7 146,349.4
202004 129,912 123,587.5 107,114.1 140,060.9
202005 123,324 129,138.3 112,664.9 145,611.7
202006 128,450 131,666.5 115,321.7 148,011.4
202007 133,354 131,035.8 114,602.2 147,469.5
202008 120,224 121,018.8 104,330.3 137,707.2
202009 138,360 131,206.9 114,830.4 147,583.4
202010 141,947 133,492.7 117,116.2 149,869.2
202011 139,246 131,586.7 115,018.1 148,155.4
202012 145,073 135,919.3 119,574.5 152,264.2
202101 138,709 134,339.3 117,770.7 150,908.0
202102 130,056 127,769.2 111,411.0 144,127.4
202103 150,785 141,402.6 124,300.2 158,505.0
202104 147,312 132,786.2 115,924.3 149,648.1
202105 144,904 138,337.0 121,475.1 155,198.9
202106 153,613 140,865.2 124,137.6 157,592.9
202107 152,068 140,234.6 123,424.5 157,044.6
202108 139,820 130,217.5 113,141.2 147,293.8
202109 156,006 140,405.6 123,649.2 157,162.0
202110 151,859 140,332.6 123,470.7 157,194.5
202111 160,137 143,144.2 126,416.6 159,871.9
202112 165,763 145,118.0 128,390.4 161,845.7
202201 164,713 143,538.0 126,580.9 160,495.2
202202 152,555 136,967.9 120,222.9 153,712.9
202203 178,617 150,601.3 133,089.0 168,113.6
202204 167,152 141,984.9 124,638.0 159,331.8
202205 179,133 149,894.5 132,660.7 167,128.3
202206 180,818 145,346.3 127,092.1 163,600.6
202207 176,602 147,074.5 129,798.5 164,350.4
202208 169,464 141,775.0 124,568.7 158,981.3
202209 186,425 147,245.5 129,898.6 164,592.4
202210 184,637 149,531.3 132,184.4 166,878.2
202211 193,054 152,343.0 135,135.1 169,550.9
202212 188,075 154,316.8 137,108.9 171,524.7
202301 193,380 152,736.8 135,295.2 170,178.3
202302 187,960 146,166.6 128,937.6 163,395.7
202303 219,056 159,800.0 141,786.0 177,814.1
202304 193,534 148,824.8 130,214.8 167,434.9
202305 214,272 156,734.4 138,814.0 174,654.8
202306 218,401 159,262.7 141,485.0 177,040.4
202307 214,091 156,273.2 138,423.5 174,122.9
202308 207,921 150,973.7 133,195.5 168,752.0
202309 214,583 158,803.0 141,002.3 176,603.8
202310 215,159 158,730.0 140,809.6 176,650.4
202311 218,482 161,541.7 143,764.0 179,319.4
202312 212,022 161,156.7 143,142.6 179,170.7
202401 231,286 164,294.3 146,516.6 182,072.0
202402 215,041 157,724.2 139,807.3 175,641.0
202403 231,044 164,281.1 145,554.2 183,008.1
202404 234,992 162,741.2 144,292.1 181,190.2
202405 244,492 168,292.0 149,842.9 186,741.0
202406 231,410 166,102.6 147,435.9 184,769.2
202407 243,850 167,830.7 149,338.8 186,322.6
202408 229,053 160,172.4 141,741.1 178,603.7
202409 243,733 165,643.0 147,068.6 184,217.3
202410 257,961 170,287.6 151,838.5 188,736.6
202411 253,844 170,740.4 152,311.6 189,169.2
202412 261,535 170,355.4 151,688.7 189,022.0

Between March 2020 to December 2024, there were 10.6 million CNS stimulants and drugs used for ADHD items prescribed to identified patients with known age and gender. This was 24% more than the 8.57 million items expected based on historical trends, and the actual number of items has consistently remained above the range of expected values since March 2022. The difference in the trend for actual items compared to the expected trend in the model continues to increase over time.

The model is based on data containing identified patients with known age and gender only. CNS stimulants and drugs used for ADHD have a relatively low patient identification rate compared to the other BNF sections included in this publication. For example, patient identification for this BNF section was 79.3% in Q1 2015/16, rising to 89.1% in Q3 of 2024/25. As a lower proportion of prescribing is included in the model data, this may have an impact on how well the model can extrapolate expected values from the data. Section 1.4 of the summary report has more information on patient identification rates and a table of rates by BNF section.

2.5. Drugs for dementia prescribing

Expected and actual prescribing activity during the COVID-19 Pandemic - BNF 4.11: Drugs for dementia

Chart
Figure 5 : Drugs for dementia prescribing
Table
Table 5: Drugs for dementia prescribing
Year Month Drugs for dementia prescribed items Drugs for dementia used for ADHD expected items 99% Prediction interval (Lower) 99% Prediction interval (Upper)
202003 338,988 351,917.6 310,014.9 393,820.3
202004 353,430 337,036.8 295,212.5 378,861.1
202005 323,304 346,431.0 304,606.7 388,255.3
202006 329,367 353,032.5 311,534.7 394,530.4
202007 338,205 359,663.0 317,939.8 401,386.3
202008 311,307 351,885.9 309,515.7 394,256.1
202009 325,076 356,458.8 314,880.5 398,037.1
202010 333,214 369,405.6 327,827.3 410,983.9
202011 319,487 358,179.9 316,113.8 400,246.0
202012 339,596 371,861.1 330,363.3 413,359.0
202101 319,711 361,116.9 319,050.8 403,183.0
202102 297,532 342,463.8 300,932.1 383,995.6
202103 331,689 378,799.6 335,378.4 422,220.8
202104 321,999 356,369.6 313,558.9 399,180.3
202105 311,439 365,763.8 322,953.1 408,574.5
202106 328,909 372,365.4 329,895.7 414,835.1
202107 332,820 378,995.9 336,316.8 421,674.9
202108 322,306 371,218.7 327,863.7 414,573.7
202109 332,910 375,791.6 333,248.8 418,334.4
202110 319,517 381,189.2 338,378.5 423,999.9
202111 331,901 385,062.0 342,592.3 427,531.7
202112 345,876 391,194.0 348,724.3 433,663.7
202201 328,777 380,449.8 337,397.4 423,502.1
202202 308,560 361,796.7 319,282.8 404,310.5
202203 343,563 398,132.5 353,670.6 442,594.3
202204 328,092 375,702.4 331,660.5 419,744.3
202205 341,386 392,645.8 348,891.1 436,400.6
202206 332,361 376,599.8 330,254.0 422,945.5
202207 333,007 390,779.5 346,917.7 434,641.3
202208 346,781 398,100.8 354,415.7 441,785.8
202209 339,899 387,575.2 343,533.3 431,617.1
202210 342,250 400,522.0 356,480.1 444,563.9
202211 350,046 404,394.8 360,705.7 448,083.9
202212 347,462 410,526.8 366,837.7 454,215.9
202301 348,718 399,782.6 355,500.4 444,064.7
202302 320,431 381,129.5 337,386.8 424,872.2
202303 364,158 417,465.3 371,729.5 463,201.1
202304 329,562 387,486.0 340,237.1 434,735.0
202305 354,929 404,429.5 358,931.4 449,927.5
202306 361,149 411,031.0 365,895.2 456,166.8
202307 354,254 410,112.3 364,793.7 455,430.9
202308 365,527 417,433.6 372,296.5 462,570.7
202309 359,131 414,457.3 369,263.1 459,651.5
202310 367,558 419,854.9 374,356.8 465,352.9
202311 375,351 423,727.6 378,591.8 468,863.4
202312 370,053 422,310.4 376,574.6 468,046.2
202401 382,365 426,664.6 381,528.8 471,800.4
202402 359,877 408,011.6 362,522.5 453,500.6
202403 363,218 421,699.7 374,153.9 469,245.5
202404 378,757 421,917.3 375,077.1 468,757.5
202405 386,852 431,311.5 384,471.3 478,151.7
202406 366,415 422,814.6 375,422.0 470,207.3
202407 403,503 436,994.3 390,045.4 483,943.3
202408 385,941 436,766.4 389,971.3 483,561.6
202409 380,741 426,240.9 379,082.6 473,399.2
202410 403,596 446,736.9 399,896.7 493,577.1
202411 389,213 443,060.5 396,271.6 489,849.3
202412 402,472 441,643.2 394,250.6 489,035.9

There were 20.1 million drugs for dementia items prescribed between March 2020 and December 2024 to identified patients with known age and gender. This was 11.6% fewer items than the 22.8 million expected to be prescribed during this time period. Previously, the actual number of items has generally remained below the range of items expected based on historical trends. However in Q3 2024/25, the number of items was within the prediction interval for both October and December.


3. Sections in this release