Medicines Used in Mental Health -
Prescribing during the COVID-19 pandemic

England - July to September 2024

Published 5 December 2024

Summary

In Q2 2024/25, CNS stimulants and drugs for ADHD items continued to increase beyond the range of expected values.

For two months in Q2 2024/25, antipsychotics were below the range of expected items based on pre-pandemic prescribing trends.

Antidepressant items and hypnotics and anxiolytics items mostly followed the expected trend during Q2 2024/25.

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 September 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	6,718,623	6,477,947	6,094,840	6,861,054
202004	6,405,919	6,181,657	5,799,267	6,564,048
202005	6,175,186	6,341,659	5,959,268	6,724,049
202006	6,397,000	6,442,317	6,062,911	6,821,722
202007	6,704,147	6,537,949	6,156,482	6,919,415
202008	6,081,061	6,334,167	5,946,786	6,721,548
202009	6,579,384	6,469,489	6,089,348	6,849,629
202010	6,733,189	6,679,626	6,299,485	7,059,767
202011	6,516,493	6,473,523	6,088,922	6,858,124
202012	6,996,042	6,737,461	6,358,056	7,116,867
202101	6,645,790	6,597,199	6,212,599	6,981,800
202102	6,273,874	6,260,495	5,880,780	6,640,211
202103	7,053,692	6,940,327	6,543,336	7,337,317
202104	6,824,034	6,505,436	6,114,028	6,896,845
202105	6,528,473	6,665,437	6,274,029	7,056,846
202106	6,945,710	6,766,096	6,377,805	7,154,387
202107	6,943,355	6,861,728	6,471,523	7,251,932
202108	6,645,072	6,657,946	6,261,561	7,054,331
202109	6,970,849	6,793,268	6,404,308	7,182,227
202110	6,688,130	6,864,804	6,473,395	7,256,212
202111	6,966,657	6,935,903	6,547,612	7,324,194
202112	7,285,887	7,061,240	6,672,949	7,449,531
202201	6,931,758	6,920,978	6,527,360	7,314,597
202202	6,496,642	6,584,274	6,195,580	6,972,969
202203	7,356,406	7,264,106	6,857,601	7,670,611
202204	6,870,160	6,829,215	6,426,550	7,231,880
202205	7,171,118	7,127,818	6,727,778	7,527,858
202206	6,987,056	6,812,673	6,388,944	7,236,401
202207	6,943,580	7,046,905	6,645,887	7,447,924
202208	7,154,688	7,120,326	6,720,923	7,519,728
202209	7,124,472	6,978,445	6,575,780	7,381,111
202210	7,056,997	7,188,583	6,785,918	7,591,248
202211	7,240,200	7,259,682	6,860,243	7,659,121
202212	7,221,932	7,385,019	6,985,580	7,784,459
202301	7,274,094	7,244,757	6,839,896	7,649,619
202302	6,703,622	6,908,053	6,508,124	7,307,983
202303	7,669,621	7,587,885	7,169,733	8,006,037
202304	6,869,362	7,014,393	6,582,407	7,446,380
202305	7,337,401	7,312,995	6,897,017	7,728,974
202306	7,453,015	7,413,654	7,000,987	7,826,320
202307	7,271,614	7,370,684	6,956,347	7,785,022
202308	7,437,947	7,444,105	7,031,426	7,856,783
202309	7,288,984	7,440,826	7,027,625	7,854,026
202310	7,420,912	7,512,362	7,096,384	7,928,340
202311	7,500,118	7,583,461	7,170,794	7,996,128
202312	7,430,734	7,570,197	7,152,045	7,988,349
202401	7,709,843	7,707,138	7,294,471	8,119,804
202402	7,238,653	7,370,433	6,954,537	7,786,329
202403	7,366,774	7,634,462	7,199,761	8,069,162
202404	7,604,938	7,615,374	7,187,125	8,043,624
202405	7,796,503	7,775,376	7,347,126	8,203,625
202406	7,257,932	7,598,832	7,165,531	8,032,132
202407	7,908,999	7,833,065	7,403,821	8,262,309
202408	7,601,710	7,767,884	7,340,046	8,195,721
202409	7,468,531	7,626,003	7,194,846	8,057,161

Between March 2020 and September 2024, there were 387 million antidepressants prescribed to identified patients with a known age and gender. This was 191,000 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	6,718,623	6,477,947	6,094,840	6,861,054
202004	6,405,919	6,181,657	5,799,267	6,564,048
202005	6,175,186	6,341,659	5,959,268	6,724,049
202006	6,397,000	6,442,317	6,062,911	6,821,722
202007	6,704,147	6,537,949	6,156,482	6,919,415
202008	6,081,061	6,334,167	5,946,786	6,721,548
202009	6,579,384	6,469,489	6,089,348	6,849,629
202010	6,733,189	6,679,626	6,299,485	7,059,767
202011	6,516,493	6,473,523	6,088,922	6,858,124
202012	6,996,042	6,737,461	6,358,056	7,116,867
202101	6,645,790	6,597,199	6,212,599	6,981,800
202102	6,273,874	6,260,495	5,880,780	6,640,211
202103	7,053,692	6,940,327	6,543,336	7,337,317
202104	6,824,034	6,505,436	6,114,028	6,896,845
202105	6,528,473	6,665,437	6,274,029	7,056,846
202106	6,945,710	6,766,096	6,377,805	7,154,387
202107	6,943,355	6,861,728	6,471,523	7,251,932
202108	6,645,072	6,657,946	6,261,561	7,054,331
202109	6,970,849	6,793,268	6,404,308	7,182,227
202110	6,688,130	6,864,804	6,473,395	7,256,212
202111	6,966,657	6,935,903	6,547,612	7,324,194
202112	7,285,887	7,061,240	6,672,949	7,449,531
202201	6,931,758	6,920,978	6,527,360	7,314,597
202202	6,496,642	6,584,274	6,195,580	6,972,969
202203	7,356,406	7,264,106	6,857,601	7,670,611
202204	6,870,160	6,829,215	6,426,550	7,231,880
202205	7,171,118	7,127,818	6,727,778	7,527,858
202206	6,987,056	6,812,673	6,388,944	7,236,401
202207	6,943,580	7,046,905	6,645,887	7,447,924
202208	7,154,688	7,120,326	6,720,923	7,519,728
202209	7,124,472	6,978,445	6,575,780	7,381,111
202210	7,056,997	7,188,583	6,785,918	7,591,248
202211	7,240,200	7,259,682	6,860,243	7,659,121
202212	7,221,932	7,385,019	6,985,580	7,784,459
202301	7,274,094	7,244,757	6,839,896	7,649,619
202302	6,703,622	6,908,053	6,508,124	7,307,983
202303	7,669,621	7,587,885	7,169,733	8,006,037
202304	6,869,362	7,014,393	6,582,407	7,446,380
202305	7,337,401	7,312,995	6,897,017	7,728,974
202306	7,453,015	7,413,654	7,000,987	7,826,320
202307	7,271,614	7,370,684	6,956,347	7,785,022
202308	7,437,947	7,444,105	7,031,426	7,856,783
202309	7,288,984	7,440,826	7,027,625	7,854,026
202310	7,420,912	7,512,362	7,096,384	7,928,340
202311	7,500,118	7,583,461	7,170,794	7,996,128
202312	7,430,734	7,570,197	7,152,045	7,988,349
202401	7,709,843	7,707,138	7,294,471	8,119,804
202402	7,238,653	7,370,433	6,954,537	7,786,329
202403	7,366,774	7,634,462	7,199,761	8,069,162
202404	7,604,938	7,615,374	7,187,125	8,043,624
202405	7,796,503	7,775,376	7,347,126	8,203,625
202406	7,257,932	7,598,832	7,165,531	8,032,132
202407	7,908,999	7,833,065	7,403,821	8,262,309
202408	7,601,710	7,767,884	7,340,046	8,195,721
202409	7,468,531	7,626,003	7,194,846	8,057,161

There were 61.6 million hypnotics and anxiolytics items prescribed to identified patients with a known age and gender between March 2020 and September 2024. This was 0.3% more than the 61.4 million items expected based on historical trends. Hypnotics and anxiolytics items stayed within the expected range of values for this period.

2.3. Drugs used in psychoses and related disorders prescribing

Expected and actual prescribing activity during the COVID-19 Pandemic - BNF 4.2: Drugs used in psychoses and related disorders

Chart

Figure 3 : Drugs used in psychoses and related disorders prescribing

Table

Table 3: Drugs used in psychoses and related disorders prescribing

Year Month	Antipsychotics prescribed items	Antipsychotics expected items	99% Prediction interval (Lower)	99% Prediction interval (Upper)
202003	1,037,021	1,046,837.0	996,054.5	1,097,619
202004	1,079,346	996,050.6	945,363.2	1,046,738
202005	1,013,552	1,021,470.8	970,783.4	1,072,158
202006	1,038,635	1,040,862.9	990,571.2	1,091,155
202007	1,079,546	1,059,286.7	1,008,721.8	1,109,852
202008	983,139	1,025,663.5	974,314.6	1,077,012
202009	1,045,054	1,041,856.8	991,467.6	1,092,246
202010	1,072,659	1,076,150.8	1,025,761.6	1,126,540
202011	1,031,105	1,037,393.6	986,413.2	1,088,374
202012	1,108,335	1,085,511.9	1,035,220.2	1,135,804
202101	1,045,985	1,054,649.0	1,003,668.6	1,105,629
202102	988,361	998,877.2	948,544.4	1,049,210
202103	1,099,637	1,108,894.0	1,056,271.3	1,161,517
202104	1,066,133	1,034,643.9	982,761.2	1,086,527
202105	1,016,025	1,060,064.1	1,008,181.4	1,111,947
202106	1,079,785	1,079,456.2	1,027,986.7	1,130,926
202107	1,085,625	1,097,880.1	1,046,156.9	1,149,603
202108	1,038,803	1,064,256.9	1,011,714.5	1,116,799
202109	1,076,513	1,080,450.2	1,028,892.0	1,132,008
202110	1,037,093	1,091,280.5	1,039,397.8	1,143,163
202111	1,072,424	1,099,450.6	1,047,981.1	1,150,920
202112	1,121,024	1,124,105.2	1,072,635.7	1,175,575
202201	1,067,745	1,093,242.4	1,041,066.7	1,145,418
202202	996,203	1,037,470.6	985,947.5	1,088,994
202203	1,117,148	1,147,487.3	1,093,603.5	1,201,371
202204	1,053,610	1,073,237.3	1,019,862.4	1,126,612
202205	1,089,856	1,122,121.2	1,069,094.2	1,175,148
202206	1,064,935	1,071,122.4	1,014,955.4	1,127,289
202207	1,057,097	1,113,009.9	1,059,853.2	1,166,167
202208	1,087,239	1,126,313.9	1,073,371.5	1,179,256
202209	1,078,049	1,095,579.9	1,042,205.0	1,148,955
202210	1,077,970	1,129,873.9	1,076,499.0	1,183,249
202211	1,097,728	1,138,044.0	1,085,096.7	1,190,991
202212	1,097,423	1,162,698.6	1,109,751.3	1,215,646
202301	1,099,341	1,131,835.8	1,078,169.7	1,185,502
202302	1,007,753	1,076,064.0	1,023,051.7	1,129,076
202303	1,144,046	1,186,080.7	1,130,653.0	1,241,508
202304	1,027,496	1,088,367.1	1,031,105.5	1,145,629
202305	1,096,232	1,137,250.9	1,082,111.3	1,192,391
202306	1,113,933	1,156,643.0	1,101,942.4	1,211,344
202307	1,083,964	1,151,603.2	1,096,681.1	1,206,525
202308	1,114,261	1,164,907.3	1,110,205.1	1,219,609
202309	1,084,095	1,157,636.9	1,102,865.5	1,212,408
202310	1,103,567	1,168,467.3	1,113,327.7	1,223,607
202311	1,114,304	1,176,637.4	1,121,936.8	1,231,338
202312	1,101,124	1,177,828.4	1,122,400.6	1,233,256
202401	1,138,946	1,193,892.8	1,139,192.2	1,248,593
202402	1,070,885	1,138,121.0	1,082,992.3	1,193,250
202403	1,083,352	1,177,746.9	1,120,125.5	1,235,368
202404	1,115,038	1,173,887.7	1,117,121.5	1,230,654
202405	1,137,206	1,199,307.9	1,142,541.7	1,256,074
202406	1,070,602	1,171,772.8	1,114,337.0	1,229,209
202407	1,174,924	1,213,660.2	1,156,762.2	1,270,558
202408	1,124,045	1,203,500.7	1,146,789.1	1,260,212
202409	1,096,454	1,172,766.7	1,115,615.0	1,229,918

From March 2020 to September 2024 there were 59.2 million antipsychotics items prescribed to identified patients with known age and gender. This was 3.0% fewer items than the 61.1 million that were expected to be prescribed. Antipsychotics items previously stayed mostly within the range of expected values, but several recent months have been lower than this range. July 2024 was the only month in Q2 2024/25 where antipsychotics items were within the range of expected values.

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	144,888	129,852.4	113,341.1	146,363.8
202004	129,913	123,592.4	107,111.9	140,072.8
202005	123,329	129,144.8	112,664.3	145,625.2
202006	128,455	131,675.4	115,323.7	148,027.2
202007	133,357	131,044.3	114,603.7	147,484.9
202008	120,225	121,027.1	104,331.6	137,722.7
202009	138,368	131,214.4	114,830.9	147,597.8
202010	141,949	133,502.0	117,118.5	149,885.4
202011	139,250	131,595.4	115,019.7	148,171.1
202012	145,075	135,926.4	119,574.7	152,278.2
202101	138,720	134,346.6	117,770.9	150,922.3
202102	130,060	127,777.8	111,412.7	144,142.9
202103	150,796	141,413.0	124,303.3	158,522.7
202104	147,321	132,793.3	115,924.2	149,662.4
202105	144,913	138,345.7	121,476.6	155,214.8
202106	153,623	140,876.4	124,141.7	157,611.2
202107	152,079	140,245.3	123,428.0	157,062.5
202108	139,829	130,228.1	113,144.5	147,311.7
202109	156,015	140,415.3	123,651.8	157,178.9
202110	151,870	140,343.3	123,474.2	157,212.4
202111	160,147	143,156.0	126,421.3	159,890.8
202112	165,771	145,127.4	128,392.7	161,862.2
202201	164,726	143,547.6	126,583.3	160,512.0
202202	152,565	136,978.8	120,226.6	153,730.9
202203	178,624	150,614.0	133,094.2	168,133.7
202204	167,163	141,994.3	124,640.1	159,348.5
202205	179,142	149,906.3	132,665.2	167,147.4
202206	180,828	145,358.2	127,096.1	163,620.2
202207	176,611	147,086.6	129,803.3	164,369.9
202208	169,475	141,788.7	124,575.0	159,002.3
202209	186,432	147,256.7	129,902.5	164,610.9
202210	184,642	149,544.3	132,190.1	166,898.5
202211	193,065	152,357.0	135,141.8	169,572.2
202212	188,091	154,328.4	137,113.2	171,543.6
202301	193,397	152,748.6	135,299.7	170,197.5
202302	187,975	146,179.7	128,943.4	163,416.1
202303	219,073	159,814.9	141,793.2	177,836.7
202304	193,556	148,835.7	130,217.7	167,453.6
202305	214,289	156,747.7	138,819.6	174,675.7
202306	218,425	159,278.4	141,493.1	177,063.6
202307	214,105	156,287.6	138,430.3	174,144.9
202308	207,948	150,989.6	133,203.8	168,775.4
202309	214,599	158,817.3	141,009.0	176,625.6
202310	215,171	158,745.3	140,817.2	176,673.3
202311	218,489	161,558.0	143,772.7	179,343.2
202312	212,034	161,169.8	143,148.0	179,191.5
202401	231,306	164,309.2	146,523.9	182,094.4
202402	215,054	157,740.3	139,815.8	175,664.8
202403	231,057	164,296.7	145,561.8	183,031.6
202404	235,006	162,755.8	144,298.9	181,212.7
202405	244,509	168,308.2	149,851.3	186,765.1
202406	231,427	166,119.7	147,445.1	184,794.3
202407	243,863	167,848.2	149,348.4	186,347.9
202408	229,071	160,190.6	141,751.5	178,629.7
202409	243,747	165,658.6	147,076.4	184,240.9

Between March 2020 to September 2024, there were 9.9 million CNS stimulants and drugs used for ADHD items prescribed to identified patients with known age and gender. This was 22.4% more than the 8.06 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 is increasing 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 89.2% in Q2 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	338,993	351,922.7	310,019.4	393,826.0
202004	353,433	337,042.6	295,217.7	378,867.4
202005	323,308	346,436.8	304,611.9	388,261.6
202006	329,372	353,037.6	311,539.3	394,536.0
202007	338,208	359,668.6	317,944.8	401,392.4
202008	311,311	351,891.6	309,520.9	394,262.4
202009	325,081	356,464.0	314,885.2	398,042.8
202010	333,221	369,411.4	327,832.6	410,990.2
202011	319,494	358,185.6	316,118.9	400,252.3
202012	339,601	371,867.4	330,369.1	413,365.8
202101	319,715	361,123.0	319,056.3	403,189.7
202102	297,534	342,470.1	300,937.8	384,002.4
202103	331,692	378,805.7	335,383.9	422,227.4
202104	322,000	356,376.7	313,565.4	399,187.9
202105	311,443	365,770.9	322,959.6	408,582.1
202106	328,910	372,371.7	329,901.5	414,842.0
202107	332,820	379,002.7	336,323.1	421,682.2
202108	322,310	371,225.7	327,870.2	414,581.3
202109	332,905	375,798.1	333,254.7	418,341.5
202110	319,526	381,196.7	338,385.4	424,007.9
202111	331,900	385,068.5	342,598.3	427,538.8
202112	345,869	391,201.5	348,731.3	433,671.8
202201	328,776	380,457.1	337,404.1	423,510.0
202202	308,558	361,804.2	319,289.8	404,318.6
202203	343,564	398,139.7	353,677.3	442,602.2
202204	328,093	375,710.7	331,668.3	419,753.2
202205	341,383	392,653.8	348,898.4	436,409.1
202206	332,365	376,608.1	330,261.8	422,954.5
202207	333,007	390,787.9	346,925.5	434,650.3
202208	346,782	398,108.6	354,423.0	441,794.3
202209	339,898	387,583.3	343,540.9	431,625.8
202210	342,251	400,530.7	356,488.3	444,573.2
202211	350,049	404,402.6	360,713.0	448,092.3
202212	347,462	410,535.6	366,846.0	454,225.3
202301	348,715	399,791.2	355,508.4	444,073.9
202302	320,437	381,138.3	337,395.0	424,881.6
202303	364,164	417,473.8	371,737.4	463,210.2
202304	329,564	387,496.0	340,246.4	434,745.6
202305	354,926	404,439.0	358,940.4	449,937.7
202306	361,148	411,039.9	365,903.5	456,176.3
202307	354,251	410,122.0	364,802.8	455,441.2
202308	365,524	417,442.7	372,305.0	462,580.4
202309	359,129	414,466.3	369,271.5	459,661.1
202310	367,555	419,864.8	374,366.2	465,363.5
202311	375,353	423,736.7	378,600.3	468,873.1
202312	370,060	422,320.9	376,584.5	468,057.3
202401	382,369	426,674.1	381,537.7	471,810.5
202402	359,883	408,021.2	362,531.6	453,510.8
202403	363,223	421,710.2	374,163.8	469,256.7
202404	378,761	421,927.8	375,086.9	468,768.6
202405	386,857	431,322.0	384,481.1	478,162.8
202406	366,420	422,825.2	375,431.9	470,218.5
202407	403,507	437,004.9	390,055.3	483,954.5
202408	385,946	436,776.8	389,981.1	483,572.6
202409	380,746	426,251.5	379,092.6	473,410.4

There were 18.9 million drugs for dementia items prescribed between March 2020 and September 2024 to identified patients with known age and gender. This was 11.7% fewer items than the 21.4 million expected to be prescribed during this time period. The actual number of items has generally remained below the range of items expected based on historical trends. However, August 2024 was the only month in Q2 2024/25 where the number of items was below the prediction interval.

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3. Sections in this release

• Medicines used in Mental Health summary
• BNF Section 4.3 - Antidepressant drugs
• BNF Section 4.1 - Hypnotics and anxiolytics
• BNF Section 4.2 - Drugs used in psychoses and related disorders
• BNF Section 4.4 - Central nervous system (CNS) stimulants and drugs used for ADHD
• BNF Section 4.11 - Drugs for dementia
• Medicines used in Mental Health background