Rising antidepressant use among youth in Croatia (2016–2023): a widening gap between the sexes

Abstract Background The increasing prevalence of mental health disorders among young people is a growing global public health concern. Previous studies show increasing antidepressant prescriptions for young people in countries such as the US, UK, Denmark, the Netherlands, and Germany between 2005 and 2012. This study examines whether similar trends are present in Croatia, using national prescribing data from the Croatian Institute of Public Health from 2016 to 2023. The findings aim to inform future clinical practices and healthcare policies to support youth mental health. Methods We analyzed all prescriptions for antidepressants (ATC code N06A) issued to individuals aged between the ages of 10 and 24, grouped into three age categories (10-14, 15-19, and 20-24), regardless of diagnosis. Trends were analyzed separately for males and females. Data were obtained from the Central Health Information System of Croatia. Joinpoint regression was used to detect significant changes in trends over time. Results A significant increase in antidepressant prescriptions was observed across all age groups, with a more pronounced rise in females. In the 10-14 group, significant change was observed in males after 2020 (APC = 13.12%), while females showed a steady increase (APC = 17.75%). Among 15-19-year-olds, prescribing continued to rise for both sexes, again more markedly in females (APC = 13.92%) than males (APC = 3.53%). In the 20-24 age group, the upward trend continued at a slower pace, with a higher increase observed in females (APC = 7.76%) compared to males (APC = 1.96%). Conclusions Antidepressant use is on the rise, especially among girls, in line with global trends. This study did not examine the causes, but possible factors include the negative impacts of digital media, especially for females who spend more time on social platforms, and a rise in reporting as a result of mental health awareness efforts. Further research is needed to understand the reasons behind this trend. Key messages • Antidepressant use in youth, especially girls, is rising - underlying causes need further investigation. • Youth mental health needs earlier, holistic, and stronger public health support.