1 Lunghi C, et al. BMJ Open 2022;12:e062197. doi:10.1136/bmjopen-2022-062197 Open access Global prevalence of antidepressant drug utilization in the community: protocol for a systematic review Carlotta Lunghi , 1,2,3,4 Michèle Dugas, 5 Jacinthe Leclerc , 6,7,8 Elisabetta Poluzzi, 4 Cathy Martineau, 1 Valérie Carnovale, 5 Théo Stéfan, 5 Patrick Blouin, 5 Johanie Lépine, 5 Laura Jalbert, 5 Nataly R Espinoza Suarez, 5 Olha Svyntozelska, 5 Marie-Pier Dery, 5 Giraud Ekanmian , 2,3,8 Daniele Maria Nogueira, 9 Pelumi Samuel Akinola, 6,10 Stéphane Turcotte, 3 Becky Skidmore, 11 Annie LeBlanc 5,12 To cite: Lunghi C, Dugas M, Leclerc J, et al. Global prevalence of antidepressant drug utilization in the community: protocol for a systematic review. BMJ Open 2022;12:e062197. doi:10.1136/ bmjopen-2022-062197 ► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online (http://dx.doi.org/10.1136/ bmjopen-2022-062197). Received 21 February 2022 Accepted 09 May 2022 For numbered affiliations see end of article. Correspondence to Dr Carlotta Lunghi; Carlotta_Lunghi@uqar.ca Protocol © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ABSTRACT Introduction Antidepressant drugs are the most frequently prescribed medication for mental disorders. They are also used off-label and for non-psychiatric indications. Prescriptions of antidepressants have increased in the last decades, but no systematic review exists on the extent of their use in the community. Methods and analysis We will conduct a systematic review to estimate the prevalence of antidepressant use in the community. We will search for studies published from 1 January 2010 in the Embase and MEDLINE databases using a combination of controlled vocabulary and keywords adjusted for each database without any language restriction. The main inclusion criterion is the presence of prevalence data of antidepressant utilization. Thus, we will include all studies with a descriptive observational design reporting the prevalence of antidepressant use in the community. Study selection (by title/abstract and full-text screening) and data extraction for included studies will be independently conducted by pairs of reviewers. We will then synthesize the data on the prevalence of antidepressant use in individuals living in the community. If possible, we will perform a meta-analysis to generate prevalence-pooled estimates. If the data allows it, we will conduct subgroup analyses by antidepressant class, age, sex, country and other sociodemographic categories. We will evaluate the risk of bias for each included study through a quality assessment using the Joanna Briggs Institute Critical Appraisal tool: Checklist for Studies Reporting Prevalence Data. DistillerSR software will be used for the management of this review. Ethics and dissemination Ethical approval is not required for this review as it will not directly involve human or animal subjects. The findings of our systematic review will be disseminated through publications in peer-reviewed journals, the Qualaxia Network (https://qualaxia.org), presentations at international conferences on mental health and pharmacoepidemiology, as well as general public events. PROSPERO registration number CRD42021247423. INTRODUCTION Of the roughly 800 million people world- wide with a mental disorder, depression and anxiety are the most frequent, and both have a significant burden of disability. 1 Antide- pressants are first-line medications to treat current mental disorders, such as depression and anxiety, 2–4 and these indications are those driving the number of prescriptions. 5 Never- theless, these medications are also prescribed for other in-label and off-label indications such as insomnia, pain, fibromyalgia, eating disorders, smoking cessation, migraine and attention-deficit/hyperactivity disorders. 5–10 In the last two decades, various epidemi- ological studies have shown an increased prevalence of antidepressant prescriptions in industrialized countries. 11–17 This could be due to an increased prevalence of current mental disorders, 18 19 which may also be due to primary care physicians’ improved ability to recognise these disorders and promptly begin pharmacological treatment. Conversely, other studies suggest a relatively stable prevalence STRENGTHS AND LIMITATIONS OF THIS STUDY ⇒ To our knowledge, this will be the first systematic review to summarize epidemiological data on anti- depressant utilization in the community. ⇒ It will also estimate the prevalence of antidepres- sant use by sex and among different age groups. ⇒ This review protocol has been built, and the review will be reported, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. ⇒ A potential limitation is that differences in popula- tions, data sources, study designs and antidepres- sants studied may preclude the meta-analysis and thus a pooled estimation of prevalence rates of an- tidepressant use. ⇒ Another limitation is the exclusion of grey literature in the search strategy. on January 10, 2024 by guest. 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