Medical use of tranquilizers and sedatives by 13-19-year-old adolescents in Estonia, 2012–2024
Year: 2025
Type: article
Abstract: Background Understanding prescribing patterns is key to improving adolescent mental health care and safe medication use. This study explored trends in medical use of tranquilizers and sedatives/hypnotics (TS) among Estonian adolescents aged 13-19 from 2012 to 2024. Methods A nationwide cross-sectional study used data from Estonian Prescription Database, covering all outpatient-dispensed TS prescriptions (ATC codes N05B, N05C). Annual prevalence per 1000, defined daily doses (DDDs) per user, and long-term use (≥180 DDD/year) were calculated by age and sex. Joinpoint regression was used to estimate annual percent change (APC). Results From 2012 to 2024, 6950 adolescents (63% girls) received 26,191 TS prescriptions. Among boys, TS prevalence increased from 7.9 to 9.9 during 2012-2018 (APC 2.8%, p < 0.05), then declined to 7.3 by 2024 (APC -3.6%, p < 0.05). In girls, prevalence rose from 11.6 to 17.9 during 2012-2021 (APC 3.7%, p < 0.05), then declined to 13.6 (APC -7.8%, p < 0.05). In 13-17-year-olds, TS use declined in boys throughout (APC -3.2%, p < 0.05), while in girls it remained stable until 2021, then declined (APC -9.2%, p < 0.05). In 18-19-year-olds, TS use rose until 2021 (boys: APC 5.8%; girls: APC 7.4%, p < 0.05), then declined-significantly in boys (APC -8.5%) and non-significantly in girls (APC -7.1%). In 2012-2024 TS DDDs/user significantly increased 1.4-fold in boys (APC 4.0%) and 1.8-fold in girls (APC 5.0%). Long-term use increased (APC 10.7%, p < 0.05). Most used substances were alprazolam (29.6%), diazepam (22.4%) and zopiclone (12.4%). Main diagnoses were anxiety (21.0%) and depression (18.4%). Psychiatry (50.1%) and primary care (36.4%) were key prescribers. Conclusions TS use increased until 2021, especially in girls and 18-19-year-olds, then declined, while intensity and long-term use continued to rise. These findings highlight the need to monitor treatment duration and dosage and to reinforce non-pharmacological mental health support. Key messages • TS use among Estonian adolescents increased during 2012–2021, then declined, especially in girls, while use intensity and long-term use continued to increase through 2024. • Findings underscore the need for cautious prescribing and expanded access to non-pharmacological mental health care.
Authors: L Veskimäe, S Vorobjov, K Pärna
Language: English
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7101393133
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