The picture in Greece

Consumption is rising everywhere — and on its own that proves nothing

According to the OECD's Health at a Glance 2025, antidepressant consumption across member countries rose by more than 40% between 2013 and 2023. At European level the range is enormous: from 26.3 defined daily doses per 1,000 inhabitants in Latvia to 164.7 in Iceland in 2023. The average across 18 European countries rose from 30.5 (2000) to 75.3 (2020).

The increase on its own does not prove overprescribing. It could equally mean that a need which used to go unmet is now being met — and there is evidence that in Europe almost half of the people with clinical depression receive no treatment at all.

That is why this page does not rest on consumption figures. Volume says nothing about appropriateness: it carries no indication, no duration, and no adherence to guidelines. The evidence that carries weight is the evidence that shows to whom and for how long — and that follows immediately.

Transparency note: one Greek figure that circulates widely (+247% since 2000) I was unable to verify in a primary source. It sits in the section “What I could not verify”, not here.

[24] OECD Health at a Glance 2025 · [17] Bindel LJ, Seifert R. Int J Clin Pharm 2026 · [48] 18-country average: analysis of OECD data, Euronews 12.11.2022

Greece is the only country where anxiolytics are rising

What follows does not come from a news report or from any secondary processing. It was queried directly from the OECD database (SDMX API, pharmaceutical consumption indicator, categories N05B anxiolytics and N06A antidepressants) and can be retrieved by anyone who repeats the same query.

Every comparable country is falling. Greece is the only one rising, and by a third. For hypnotics (N05C) the picture is the same: from 5.2 to 7.5, an increase of 44%, while France and Germany decline.

For antidepressants the rise is steady and uninterrupted: 48.1 (2015) → 61.0 (2019) → 65.8 (2020) → 73.1 (2022) → 76.5 (2023) → 80.2 (2024). An increase of 67% in nine years.

How this should and should not be read: data coverage differs by country — for Greece it covers EOPYY, roughly 95% of the population, excluding hospital dispensing, non-reimbursed medicines and OTC. That is why I compare trends within each country and not absolute levels between countries; the figure of 2.1 for Italy is almost certainly a coverage artefact, since the Italian national report gives roughly 50. And DDD is not a number of people: it is volume in theoretical doses, and it does not translate into a percentage of the population.

The trend, however, has no such problem. And the trend says that after the FDA warning of 2020 and the MHRA warning of 2026, the rest of Europe is withdrawing from benzodiazepines — and Greece is moving in the opposite direction.

[49] OECD, Health Statistics — Pharmaceutical consumption (SDMX API, dataflow HEALTH_PHMC@DF_PHMC_CONSUM), query for N05B, N05C and N06A, countries GRC/ITA/PRT/ESP/DEU/FRA/GBR, 2015–2024 · [50] Ma et al. Global trends in the consumption of benzodiazepines and Z-drugs in 67 countries, Sleep 2023;46(10):zsad124 — Greece 40.11 (2008) → 44.94 (2018) DDD, +0.65/year (p=0.018), against the global downward trend

1.2 million hypnotic prescriptions in four years

An analysis of the Greek national prescription database for Z-drugs (mostly zolpidem — Stilnox) over 2018–2021 recorded 1,229,842 prescriptions to 156,554 patients.

These hypnotics were approved for short-term use. A median of eight prescriptions per patient over three years is not short-term use. And 73.1% aged over 65 runs directly against the Beers Criteria, which class this group among potentially inappropriate medications for that age, because of falls and hip fractures.

[11] BMC Psychiatry 2023;23:370

A finding that overturns the usual narrative

In the same Greek study, the distribution of prescribing doctors was:

Seven in ten hypnotic prescriptions in Greece are written by internists and general practitioners. Barely one in ten by a psychiatrist.

Which means that aiming exclusively at psychiatry misses the target. Overprescribing of sedatives and hypnotics in Greece is a primary care problem: time pressure in the consulting room, almost no publicly funded access to psychotherapy, and a system in which the prescription is the fastest tool available.

[11] BMC Psychiatry 2023;23:370

Between 45 and 59, psychiatric drugs are near the top of the list

An analysis of the Greek e-prescription database covering 2015–2021, with near-total population coverage, places nervous system drugs (ATC category N) fourth by volume across all categories, at 10.6% of total pharmaceutical expenditure.

In the 45–59 age group, psycholeptics (N05) and psychoanaleptics (N06) are among the categories accounting for more than half of total consumption, with N05 showing a significant increase from 2015 to 2021. The authors link the change to the economic crisis and the pandemic.

This matters because it shows the Greek problem is not confined to elderly people on sleeping pills: it reaches the working-age population too.

[25] Mavridoglou G, Polyzos N. Healthcare (Basel) 2024;12(22):2312 · doi:10.3390/healthcare12222312