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IntroductionPersons using the Internet generate large amounts of health-related data, which are increasingly used in modern health sciences.Objectives/aimsWe analysed the relation between annual prescription volumes (APV) of several antidepressants with marketing approval in Germany and corresponding web search query data generated in Google to test, if web search query volume may be a proxy for medical prescription practice.MethodsWe obtained APVs of several antidepressants related to corresponding prescriptions at the expense of the statutory health insurance in Germany from 2004–2013. Web search query data generated in Germany and related to defined search-terms (active substance or brand name) were obtained with Google Trends. We calculated correlations (Pearson's r) between the APVs of each substance and the respective annual “search share” values; coefficients of determination (R2) were computed to determine the amount of variability shared by the two variables.ResultsSignificant and strong correlations between substance-specific APVs and corresponding annual query volume were found for each substance during the observational interval: agomelatine (r = 0.968; R2 = 0.932; P = 0.01), bupropion (r = 0.962; R2 = 0.925; P = 0.01), citalopram (r = 0.970; R2 = 0.941; P = 0.01), escitalopram (r = 0.824; R2 = 0.682; P = 0.01), fluoxetine (r = 0.885; R2 = 0.783; P = 0.01), paroxetine (r = 0.801; R2 = 0.641; P = 0.01), and sertraline (r = 0.880; R2 = 0.689; P = 0.01).ConclusionsAlthough the used data did not allow to perform an analysis with a higher temporal resolution our results suggest that web search query volume may be a proxy for corresponding prescription behaviour. However, further studies analysing other pharmacologic agents and prescription data that facilitates an increased temporal resolution are needed to confirm this hypothesis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionDrug-induced liver injury is a major problem of pharmacotherapy and is also frequent with anti-depressive psychopharmacotherapy.Objectives/aimsHowever, there are only few studies using a consistent methodologic approach to study hepatotoxicity of a larger group of antidepressants.MethodsWe performed a quantitative signal detection analysis using pharmacovigilance data from the Uppsala monitoring center from the WHO that records adverse drug reaction data from worldwide sources; we calculated reporting odds ratios (ROR) as measures for disproportionality within a case-/non-case approach for several frequently prescribed anti-depressants.ResultsBoth positive controls, amineptine (ROR 38.4 [95% CI: 33.8–43.6]) and nefazodone (ROR 3.2 [95% CI: 3.0–3.5]), were statistically associated with hepatotoxicity. Following amineptine, agomelatine (ROR 6.4 [95% CI: 5.7–7.2]) was associated with the second highest ROR, followed by tianeptine (ROR 4.4 [95% CI: 3.6–5.3]), mianserin (ROR 3.6 [95% CI: 3.3–3.4]) and nefazodone.ConclusionsIn line with previous studies our results support the hypothesis that agomelatine and several other anti-depressants may be associated with relevant hepatotoxicity. However, the used data and applied method do not allow a quantitative evaluation of hepatotoxicity or assessment of substance–specific differences regarding the extent of hepatotoxicity.Disclosure of interestThe authors have not supplied their declaration of competing interest.