Figure S1 - The raw numbers of prescribed antidepressant items by class, from 1998 to 2018. MAOI = monoamine oxidase inhibitor, SNRI = selective serotonin-norepinephrine reuptake inhibitor, SSRI = selective serotonin reuptake inhibitor. Figure S2 - The raw numbers of prescribed antidepressant items for the ten most commonly prescribed antidepressants (in 2018), from 1998 to 2018. Figure S3 - Practice level percentile charts for the proportions of the ten most commonly prescribed antidepressants (in 2018), prescribed between August 2010 and November 2019. Deciles are in blue, with median shown as a heavy blue line, and extreme percentiles are in red. Figure S4 - Practice level percentile charts for the proportions of specific MAOIs prescribed between August 2010 and November 2019. Deciles are in blue, with median shown as a heavy blue line, and extreme percentiles are in red. Figure S5 - CCG level heat map for the percentage proportions of MAOIs prescribed between December 2018 and November 2019. MAOI = monoamine oxidase inhibitor. Figure S6 - CCG level heat maps for the percentage proportions of paroxetine, dosulepin, and trimipramine prescribed between December 2018 and November 2019. Table S1 - Antidepressant drugs, by category. MAOI = monoamine oxidase inhibitor, SNRI = selective serotonin-norepinephrine reuptake inhibitor, SSRI = selective serotonin reuptake inhibitor. Class Drug MAOI Isocarboxazid, moclobemide, phenelzine, tranylcypromine SNRI Duloxetine, venlafaxine SSRI Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline Tricyclic Amitriptyline, amoxapine, clomipramine, dosulepin, doxepin, imipramine, lofepramine, nortriptyline, protriptyline, trimipramine Other Agomelatine, bupropion, flupentixol, maprotiline, mianserin, mirtazapine, nefazodone, oxitriptan, reboxetine, trazodone, tryptophan, vortioxetine Table S2 - Basic descriptive statistics For practice level class-speciFic proportions oF antidepressants prescribed between December 2018 and November 2019. IDR = interdecile range, IQR = interquartile range, MAOI = monoamine oxidase inhibitor, SNRI = selective serotonin- norepinephrine reuptake inhibitor, SSRI = selective serotonin reuptake inhibitor. Standard Lowest Lower Upper Highest Mean Median IQR IDR deviation Decile quartile quartile Decile SSRI % 54.5 6.6 46.4 50.5 54.7 58.5 62.2 8.0 15.8 Tricyclic % 21.5 5.4 15.3 18.2 21.2 24.5 27.9 6.3 12.6 Other % 14.7 5.3 8.7 11.1 14.2 17.6 21.0 6.5 12.2 SNRI % 9.2 3.3 5.5 7.1 9.0 11.1 13.3 3.9 7.7 MAOI % 0.1 0.2 0 0 0 0 0.2 0 0.2 Table S3 - Practice level basic descriptive statistics For the proportions oF the ten most prescribed antidepressants (in 2018) prescribed between December 2018 and November 2019. IDR = interdecile range, IQR = interquartile range. Standard Lowest Lower Upper Highest Mean Median IQR IDR deviation decile quartile quartile decile Sertraline% 21.6 5.8 14.6 18.0 21.4 25.1 28.6 7.1 14.0 Citalopram % 20.0 6.1 12.6 15.8 19.7 23.8 27.8 8.0 15.2 Amitriptyline % 18.9 5.2 13.0 15.6 18.6 21.8 25.1 6.1 12.1 Mirtazapine % 12.9 4.9 7.5 9.6 12.4 15.5 18.6 5.8 11.1 Fluoxetine % 9.1 3.3 5.4 6.9 8.7 10.9 13.2 3.9 7.9 Venlafaxine % 6.0 2.6 3.1 4.3 5.8 7.5 9.3 3.2 6.2 Duloxetine % 3.2 2.0 1.1 1.8 2.8 4.1 5.7 2.3 4.6 Paroxetine % 1.9 1.3 0.7 1.2 1.7 2.4 3.3 1.3 2.6 Trazodone % 1.4 1.6 0 0.4 0.9 1.9 3.3 1.5 3.3 Escitalopram % 1.8 2.1 0.2 0.6 1.1 2.1 3.9 1.6 3.7 Table S4 - Practice level basic descriptive statistics For the proportions oF speciFic MAOIs prescribed between December 2018 and November 2019. IDR = interdecile range, IQR = interquartile range. Standard Lowest Lower Upper Highest Mean Median IQR IDR deviation decile quartile quartile decile Moclobemide % 0 0.1 0 0 0 0 0.1 0 0.1 Phenelzine % 0 0.1 0 0 0 0 0.1 0 0.1 Tranylcypromine % 0 0.1 0 0 0 0 0 0 0 Isocarboxazid % 0 0 0 0 0 0 0 0 0 Table S5 - Unadjusted and adjusted estimates for any practice-level prescribing of dosulepin and trimipramine from logistic regression analysis. CI = confidence interval, GP = general practitioner, IMD = Index of Multiple Deprivation, OR = odds ratio, QOF = Quality Outcomes Framework. Mean % of Unadjusted OR Adjusted OR dosulepin and (95% CI) (95% CI) trimipramine Proportion of 0 to 11.1 0.74 Reference Reference patients over 65 11.2 to 15.7 0.90 1.16 (1.13 to 1.18) 1.23 (1.20 to 1.26) 15.7 to 19.25 0.94 1.24 (1.21 to 1.26) 1.36 (1.33 to 1.40) 19.26 to 23.2 1.01 1.35 (1.33 to 1.38) 1.53 (1.49 to 1.57) 23.2 to 90.3 1.08 1.46 (1.43 to 1.48) 1.59 (1.55 to 1.64) Proportion of 15.7 to 44.4 0.85 Reference Reference patients with a long term health 44.4 to 49.7 0.97 1.15 (1.13 to 1.18) 1.06 (1.04 to 1.09) condition 49.7 to 53.9 0.93 1.11 (1.09 to 1.13) 0.99 (0.97 to 1.01) 53.9 to 58.6 0.99 1.15 (1.13 to 1.17) 1.02 (1.00 to 1.04) 58.6 to 100 0.94 1.09 (1.07 to 1.11) 0.98 (0.96 to 1.00) List size <4.3 0.95 Reference Reference (thousands) 4.3 to 6.4 0.91 0.98 (0.96 to 1.00) 0.98 (0.96 to 1.00) 6.4 to 8.8 0.96 1.01 (0.99 to 1.04) 1.01 (0.99 to 1.04) 8.8 to 12.0 0.94 1.01 (0.99 to 1.03) 1.04 (1.02 to 1.07) >12.0 0.91 0.98 (0.96 to 1.00) 1.04 (1.02 to 1.06) GPs per 1000 <3.6 0.91 Reference Reference patients 3.7 to 4.8 0.99 1.06 (1.05 to 1.08) 1.04 (1.03 to 1.06) 4.8 to 5.9 0.93 1.01 (0.99 to 1.03) 0.99 (0.97 to 1.01) 5.9 to 7.4 0.93 0.99 (0.97 to 1.00) 0.98 (0.96 to 1.00) >7.4 0.92 0.98 (0.96 to 0.99) 0.94 (0.92 to 0.95) Rurality Rural village and 0.93 Reference Reference dispersed Rural town and 0.85 0.94 (0.91 to 0.96) 0.95 (0.89 to 1.01) fringe Urban city and town 0.87 0.95 (0.94 to 0.96) 0.87 (0.84 to 0.90) Urban minor 1.05 1.11 (1.09 to 1.12) 0.92 (0.89 to 0.95) conurbation Urban major 1.28 1.35 (1.32 to 1.39) 1.11 (1.06 to 1.16) conurbation IMD Least deprived 1.05 Reference Reference | 1.04 1.00 (0.99 to 1.02) 1.01 (0.99 to 1.02) | 0.88 0.86 (0.85 to 0.87) 0.94 (0.92 to 0.96) | 0.84 0.81 (0.79 to 0.82) 0.91 (0.89 to 0.93) Most deprived 0.86 0.82 (0.81 to 0.84) 0.94 (0.91 to 0.96) QOF sCore 160-532 0.95 Reference Reference 532-546 0.96 1.01 (0.99 to 1.02) 1.04 (1.02 to 1.06) 546-554 0.92 0.98 (0.96 to 0.99) 1.00 (0.98 to 1.01) 554-558 0.95 0.97 (0.96 to 0.99) 0.97 (0.95 to 0.98) 558-559 0.90 0.96 (0.94 to 0.97) 0.93 (0.92 to 0.95) .