1.1 Scope

This publication provides information on 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 or the Channel Islands. The publication does not include data on medicines used in hospitals, prisons or prescribed by private doctors.

The five sections of the British National Formulary (BNF) included in this publication cover medicines which are primarily used to treat anxiety, depression, psychosis, attention deficit hyperactivity disorder (ADHD), and dementia. We do not capture the clinical indication of a prescription, so there may be instances where these drugs are used for other conditions.

This publication does not discuss the demographic data associated with the provision of these medicines, but this information is available in the supporting summary tables which accompany this release.

Medicines are not the only way to treat mental health conditions, and this publication does not capture information on the use of other mental health services, such as psychological therapies. Therefore, this publication may not give a complete picture of the number of people receiving treatment for mental health conditions. Information on where to find related statistics can be found in Section 4.

1.2. Definitions

1.3. Time periods

The data in this publication covers the period from April 2018 to September 2024. Q1, Q2, Q3, and Q4 refer to different quarterly periods within a financial year. Q2 2024/25 relates to July to September 2024.

These statistics cover the period of the coronavirus (COVID-19) pandemic. A detailed timeline of events and restrictions in the UK during this time can be found on the UK parliament website. The impact of COVID-19 should be considered when comparing across time periods

1.4. Patient identification

When the NHSBSA processes prescriptions it is not always possible to capture the NHS number of the patient. Table 1 shows the proportion of items for which a patient could be identified. This means that the data relating to patient counts represents most, but not all, patients. Patient identification rates going back to Q1 2015/16 can be found in the individual summary tables for each BNF section.

Due to an increase in digital prescription processing through the Electronic Prescription Service (EPS) during the COVID-19 pandemic, more patients were identified in 2020/21 and 2021/22 compared to previous years then stabilised. When patient identification rates increase, any increases in the number of identified patients between periods are likely to be an overestimate of the actual increase in patient numbers. This is because the proportion of patients who could be identified has increased. Conversely, any decrease over the same period is likely to be an underestimate of the actual decrease.

These statistics do not include any information that is personally identifiable. You can find more information about how the NHSBSA protect personal information in the confidentiality and access statement.

3.1. Antidepressant drugs

Antidepressant drugs are licensed to treat major depression. Health professionals use the words depression, depressive illness or clinical depression to refer to depression. It is a serious illness and very different from the common experience of feeling unhappy or fed up for a short period of time. Depressed people may have feelings of extreme sadness that can last for a long time. These feelings are severe enough to interfere with daily life, and can last for weeks, months or years, rather than days.

It should be noted that antidepressant drugs are used for indications other than depression, for example migraine, chronic pain, myalgic encephalomyelitis (ME), or a range of other conditions. Clinical indication isn’t captured by the NHSBSA. Therefore, the statistics on these drugs do not relate solely to prescribing for depression.

You can find more information about depression on the NHS website.

3.2. Hypnotics and anxiolytics

Hypnotics and anxiolytics are used to treat insomnia and anxiety respectively.

Insomnia is difficulty getting to sleep or staying asleep for long enough to feel refreshed in the morning, despite there being enough opportunity to sleep. Difficulty falling asleep is the most common problem with insomnia and is also known as sleep-onset insomnia. An insomniac may also experience:

• waking in the night
• not feeling refreshed after sleep and not being able to function normally during the day
• feeling irritable and tired and finding it difficult to concentrate
• waking when they have been disturbed from sleep by pain or noise
• waking early in the morning

Anxiety is a feeling of unease, such as worry or fear, which can be mild or severe. Everyone experiences feelings of anxiety at some point in their life and feeling anxious is sometimes perfectly normal. However, people with generalised anxiety disorder (GAD) find it hard to control their worries. Their feelings of anxiety are more constant and often affect their daily life. There are several conditions for which anxiety is the main symptom. Panic disorder, phobias and post-traumatic stress disorder can all cause severe anxiety.

You can find more information about insomnia and anxiety from the NHS website.

3.3. Drugs used in psychoses and related disorders

People experiencing psychoses may report hallucinations (seeing or hearing things that other people cannot see or hear) or delusional beliefs (believing things that are not actually true), and may exhibit personality changes and thought disorder. As well as this, they may experience difficulties with social interaction and impairment in carrying out daily life activities.

You can find more information about psychoses and related disorders on the NHS website.

3.4. Central nervous system (CNS) stimulants and drugs used for ADHD

Attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD) refer to a range of problem behaviours associated with poor attention span. These may include impulsiveness and hyperactivity, as well as inattentiveness; behaviours that often prevent children and adults from learning and socialising. ADHD is sometimes referred to as hyperkinetic disorder (HD).

You can find more information about ADHD on the NHS website.

3.5. Drugs for dementia

Dementia is a disease that leads to progressive loss of brain function typified by memory loss, confusion, speech difficulties and problems in understanding. There are over 100 different types of dementia. The most common forms are:

• Alzheimer’s disease
• Vascular dementia
• Dementia with Lewy bodies
• Pick’s disease
• Huntington’s disease
• Alcohol-related dementia
• HIV/AIDS related dementia

Dementia mainly affects older people but can also occur in people as young as 30 due to either alcohol abuse or HIV/AIDS. No cure for dementia currently exists. However, drugs may slow the rate of decline or in some patients make a small improvement in symptoms. Despite this, disease progression is inevitable.

You can find more information about the various types of dementia on the NHS website.

3.6. Related statistics and resources

Prescribing of medicines in primary care is only part of the bigger picture for mental health care in England. The NHS England mental health data hub has links to statistics on a range of related topics which may provide further context. These include a mental health bulletin, reports on children and young people’s mental health surveys, dementia assessment and referral statistics, and more.

4.1. Planned changes to this publication

This is an official statistic release. We will regularly be reviewing the methodology used within the statistics.

4.2 Statistical Disclosure Control (SDC)

Statistical disclosure control has been applied to these statistics. Patient count, items, and net ingredient cost (NIC) have been redacted in the supporting summary tables if they relate to fewer than 5 patients. Further information about our statistical disclosure control protocol can be found on our website.

4.3. Rounding

The high-level figures in this statistical summary have been rounded where appropriate for clarity. In most cases rounding has been to two significant figures for numbers over 1 million or percentages, and 3 significant figures for smaller numbers. This is to make this narrative as accessible as possible to all readers. The summary tables released with this publication allow users to investigate this data at lower levels of granularity. Figures in the supplementary tables have not been rounded.

4.4. Trends during COVID-19

The number of items for each BNF section in the 55-month period March 2020 to September 2024 were compared to the number of items expected to be prescribed based on trends from the ‘pre-COVID-19’ period. The monthly data for April 2015 to February 2020 was used to extrapolate expected figures for March 2020 to September 2024. These figures were extrapolated according to:

• the trends 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

This model states expected figures if trends had continued as before but doesn’t confirm causation of any differences. Factors other than COVID-19 may have influenced prescribing, such as:

• changes in patient behaviour, demographics, or morbidity
• external environmental factors that could drive prescribing
• any (and all) policy initiatives and guidance
• other local priorities and resources