Drinking patterns and antidepressant medication - a prospective register-linked study among 40 to 60-year-old employees.

Purpose: To examine the association between drinking patterns and subsequent antidepressant medication using register-linked data.

Methods: The Helsinki Health Study survey (2000-02) of 40- to 60-year-old employees was linked with antidepressant medication data from registers of the Social Insurance Institution of Finland. Drinking patterns included weekly amount of drinking, binge drinking and problem drinking. Cox regression analysis was used to calculate hazard ratios (HR) for the first antidepressant medication purchase during five-year follow-up. Gender, age, occupational position, marital status, relative weight, smoking and leisure-time physical activity were included as covariates. The study included 5727 employees with no antidepressant purchase during 3 years preceding the baseline.

Results: Heavy drinking was associated with an increased risk of antidepressant medication compared to moderate drinking (HR 1.53, 95% CI 1.18-1.99). Non-drinkers (1.43, 1.03-1.97), occasional binge drinkers (1.27, 1.06-1.52) and frequent binge drinkers (1.35 (1.02-1.77) showed an association with antidepressant medication compared to non-bingeing drinkers. Problem drinking was associated with antidepressant medication (1.84, 1.54-2.19). The associations remained after adjusting for occupational position and for marital status. The associations concerning heavy drinking and problem drinking remained also after adjusting for relative weight and health behaviours. An additional analysis among participants with prior antidepressant medication before baseline, showed no associations between drinking patterns and subsequent antidepressant medication during the follow-up.

Conclusion: Alcohol drinking is associated with antidepressant medication among employees. The association is not limited to problem drinking. Paying attention to heavy, binge and problem drinking might help prevent depression.