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Relationship between antidepressant and anxiolytic/hypnotic prescribing: a mixed-methods study
Jill Morrison1, Mary-Jane Anderson, Sara Mac Donald
1Section of General Practice, Division of Community Based Sciences, Faculty of Medicine, University of Glasgow, Glasgow, UK. j.morrison@clinmed.gla.ac.uk
The European Journal of General Practice
|December 25, 2008
Summary
The rise in antidepressant prescriptions in Scotland is partly explained by their increased use for anxiety, substituting for anxiolytics and hypnotics. This shift was observed at the general practice level.
Area of Science:
- Pharmacovigilance
- General Practice Research
- Mental Health Prescribing Patterns
Background:
- Antidepressant prescribing in Scotland has significantly increased.
- The underlying reasons for this prescribing trend remain unclear.
Purpose of the Study:
- To determine if increased antidepressant prescribing correlated with decreased anxiolytic and hypnotic prescribing.
- To examine this relationship within Scottish general practices.
- To explore general practitioners' (GPs) perspectives on using antidepressants for anxiety.
Main Methods:
- Analysis of routine prescribing data from 942 Scottish general practices.
- Interviews with 63 GPs across 30 practices.
- Quantification of prescribed antidepressants, anxiolytics, and hypnotics (defined daily doses).
Main Results:
- Antidepressant use rose from 28.9 to 128.3 million defined daily doses (DDDs) between 1992/3 and 2004/5.
- Anxiolytic and hypnotic prescribing decreased from 64.2 to 55.1 million DDDs during the same period.
- A weak positive correlation was found between antidepressant and anxiolytic/hypnotic prescribing levels; GPs noted overlap in treating anxiety and depression, sometimes substituting benzodiazepines.
Conclusions:
- A portion of the increased antidepressant prescribing is attributed to the substitution of benzodiazepines for anxiety treatment.
- General practitioners acknowledge the use of antidepressants for anxiety, indicating a shift in prescribing practices.
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