Ongoing initiatives within the Scottish National Health Service to affect the prescribing of SSRIs and their influence

Increasing use of SSRIs in Scotland, coupled with safety concerns with some SSRIs, and the increasing availability of generic SSRIs, have resulted in multiple initiatives to improve the quality and efficiency of prescribing. Our aim is to assess their influence to provide future direction. Materials & methods: PCA database to document utilisation and expenditure on SSRIs between 2001 to 2017 and document initiatives. Results: Multiple interventions over the years increased INN prescribing up to 99.9% lowering overall costs. This coupled with initiatives to limit escitalopram prescribing due to concerns with its value resulted in a 73.7% reduction in SSRI expenditure between 2001 and 2017 despite a 2.34-fold increase in utilisation. Safety warnings resulted in a significant reduction in the prescribing of paroxetine, citalopram and escitalopram alongside a significant increase in sertraline Conclusion: Multiple initiatives have increased the quality and efficiency of SSRI prescribing in Scotland providing direction to others.