Publication date: Jul 17, 2026
While antidepressant therapy is a common treatment for post-COVID mental health symptoms, little is known about initiations of antidepressants in patients after COVID-19 and how sociodemographic factors modify this risk. This study investigated whether adults infected by COVID-19 were more likely to initiate antidepressant therapy compared with non-infected individuals, and examined the influence of socioeconomic factors on initiation patterns. We conducted a nationwide registry-based cohort study using data from the SCIFI-PEARL project, including all adults (≥ 18 years of age) in Sweden from 1 March 2020 to 31 March 2022. Exposed individuals had a COVID-19 infection, and unexposed individuals were matched 1:1 by sex and birth year. Stratified Cox regression models were used to estimate the risk of antidepressant (ATC: N06A) initiation, adjusting for socioeconomic status, and Charlson Comorbidity Index. The cohort included 2,666,510 individuals (1,333,255 exposed and unexposed). Exposed individuals had a 16% higher risk of initiating antidepressants compared with unexposed individuals after full adjustment (HR: 1. 16, 95% CI:1. 15-1. 17). The risk reduced by roughly 43% when we adjusted for post-index healthcare contacts as potential mediator. Higher risks were observed for unmarried (HR: 1. 14, 95% CI:1. 13-1. 16), or unemployed/retired (HR 1. 14, 95% CI: 1. 13-1. 16) individuals. Conversely, higher educational level and being born outside Sweden were associated with lower risk of initiation of antidepressant, (HR:0. 70, 95% CI:0. 68-0. 71) and (HR:0. 92, 95% CI: 0. 91-0. 94), respectively. COVID-19 exposure was associated with an increased risk of initiating antidepressant therapy, particularly among socioeconomically vulnerable groups. Differences by education and immigrant status suggest disparities in access to healthcare.
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| Concepts | Keywords |
|---|---|
| Antidepressant | |
| COVID-19 | |
| Drug unitization | |
| Registry-based study | |
| Sweden |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| drug | DRUGBANK | Pearl (hyriopsis cumingii) |
| disease | MESH | infection |
| drug | DRUGBANK | Timonacic |
| disease | MESH | included |
| disease | MESH | Long Covid |
| disease | MESH | acute respiratory distress syndrome |
| disease | MESH | anxiety |
| disease | MESH | face |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | Death |
| disease | MESH | HRs |
| disease | MESH | +SD |
| disease | MESH | chronic conditions |
| pathway | REACTOME | Reproduction |
| disease | MESH | psychiatric disorder |
| disease | MESH | Chai |
| disease | MESH | Lam |
| disease | MESH | ICH |
| drug | DRUGBANK | Trestolone |
| drug | DRUGBANK | Silver |
| disease | MESH | major depressive disorder |
| disease | MESH | Ito |