Hakan Yilmaz

Introduction: The extraordinary circumstances due to the COVID‐19 pandemic and related restrictions altered the management of mental health disorders, including the use of antipsychotics. We aimed to examine the changes in antipsychotic utilization and expenditure in Turkey throughout pandemic‐associated restriction periods. Methods: Nationwide drug sales and projected prescribing data from 01.03.2018 to 31.12.2022 were obtained from IQVIA Turkey. We assessed average monthly consumption, expenditure, and quarterly prescribing levels across three periods: “before restrictions” (BfR, 01.03.2018–31.03.2020), “during restrictions” (DuR, 01.04.2020–31.03.2022), and “after restrictions” (AfR, 01.04.2022–31.12.2022). Consumption and prescribing levels were measured using “defined daily dose/1000 inhabitants/day” (DID) parameter. Results: Antipsychotic consumption throughout periods increased from 8.4 ± 0.6 DID in BfR to 9.9 ± 1.6 DID in DuR ( p < 0.001), and to 10.1 ± 0.9 DID in AfR ( p < 0.001 vs. BfR). Atypical antipsychotics followed the overall trend, whereas typical antipsychotics remained stable from DuR to AfR, deviating from this pattern. Antipsychotic expenditure rose from €16.7 m ± 1.1 m in BfR to €19.0 m ± 2.7 m in DuR ( p < 0.001), then shifted to €18.3 m ± 1.9 m in AfR ( p > 0.05 vs. BfR and DuR). High‐cost antipsychotic use increased after the pandemic onset ( p < 0.001) and remained elevated in AfR ( p < 0.001). Prescribing for schizophrenia declined from 2.2 ± 0.3 DID in BfR to 1.3 ± 0.2 DID in DuR ( p < 0.001), then escalated to 1.8 ± 0.3 DID in AfR ( p = 0.015 vs. DuR). Conclusions: Our study revealed an upsurge in antipsychotic utilization in Turkey with the start of the pandemic. A range of factors may have contributed, notably the impact of policies facilitating the dispensing of chronic medications without prescription or a tendency towards polypharmacy.

Background: The prevalence of mental health disorders rose when the impact of the COVID-19 pandemic was most pronounced, potentially altering the consumption of antidepressants and anxiolytics. We aimed to evaluate changes in antidepressant and anxiolytic utilization throughout the COVID-19 pandemic era. Methods: Nationwide drug sales and prescribing data through 01.03.2018–31.12.2022 were sourced from IQVIA Turkey. We assessed mean monthly consumption and expenditure trends of antidepressants and anxiolytics, along with quarterly prescribing levels, across three periods: “before restrictions” (BfR, 01.03.2018–31.03.2020), “during restrictions” (DuR, 01.04.2020–31.03.2022), and “after restrictions” (AfR, 01.04.2022–31.12.2022), using “defined daily dose per 1000 inhabitants per day” (DID) measure. Results: Antidepressant consumption escalated from 47.9 ± 4.3 DID in BfR to 56.2 ± 8.9 DID in DuR (P < .001), reaching 60.5 ± 8.9 DID in AfR (P < .001 vs. BfR). Anxiolytic use increased from 2.0 ± 0.3 DID in BfR to 2.5 ± 0.3 DID in DuR (P < .001), and to 2.7 ± 0.3 DID in AfR (P < .001 vs. BfR). Expenditure also rose in DuR and AfR for both drug groups (P < .01). Prescribing trends for antidepressants decreased in DuR (P < .001) and showed an insignificant rebound in AfR (P > .05 vs. BfR and DuR), while anxiolytic prescribing surged in DuR (P = .001 vs. BfR) and subsequently reverted in AfR (P > .05 vs. BfR and DuR). These patterns were consistent across both new and ongoing users. Conclusions: This study showed a sustained increase in the use of antidepressants and anxiolytics following the onset of pandemic despite fluctuations in prescribing, implying a heightened need for pharmacotherapy and greater burden of depressive and anxiety disorders, especially for the latter.

Delay discounting (DD) is associated with smoking behavior and relapses. Episodic future thinking (EFT) is one of the leading interventions shown to reduce DD. The 1-month follow-up study with 60 participants that employed EFT as active intervention and episodic recent thinking (ERT) as control intervention was conducted in participants receiving smoking cessation treatment. In EFT group, there was significant decrease in DD rates from pre-intervention to post-intervention ( p = 0.009), whereas no significant change was observed in ERT group ( p = 0.497). DD rates in EFT group did not change significantly over 1 month ( p = 0.059), while decrease was detected in ERT group ( p = 0.011). Smoking cessation rates between groups were similar ( p = 0.486). Adherence with completing follow-up evaluation forms and performing relevant exercises was higher in EFT group ( p = 0.038, p = 0.006). Adding EFT to usual smoking cessation treatment did not increase smoking cessation rates, however feasibility of the self-administered exercises needs to be improved to clarify clinical effects.

Irritability,mood,depression,anxiety,stress