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Increased polysedative use in veterans with posttraumatic stress disorder.
Nancy C Bernardy1, Brian C Lund, Bruce Alexander
1National Center for PTSD, Veterans Affairs Medical Center, White River Junction, VT, USA; Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Pain Medicine (Malden, Mass.)
|December 18, 2013
Summary
Polysedative prescribing, using three or more sedating medication classes, increased among veterans with posttraumatic stress disorder (PTSD) from 2004 to 2011. Opioid and benzodiazepine combinations were most common.
Area of Science:
- Pharmacology
- Psychiatry
- Veterans Health
Background:
- Treatment for posttraumatic stress disorder (PTSD) in veterans is complex due to co-occurring conditions like pain and insomnia.
- Concurrent pharmacologic treatments can lead to polypharmacy and safety concerns.
Purpose of the Study:
- To characterize polysedative prescribing patterns among veterans diagnosed with PTSD.
- To analyze trends in sedative medication use over an eight-year period.
Main Methods:
- Utilized National Department of Veterans Affairs (VA) data from 2004 to 2011.
- Identified veterans with PTSD using ICD-9 codes.
- Assessed annual prescribing of benzodiazepines, hypnotics, atypical antipsychotics, opioids, and muscle relaxants.
- Determined polysedative use via longitudinal refill patterns.
Main Results:
- Prevalence of concurrent use of three or more sedative classes among veterans with PTSD rose from 9.8% in 2004 to 12.1% in 2011.
- Higher rates of polysedative use were observed in women, rural residents, younger adults, Native Americans, and Whites.
- The most frequent combination involved concurrent opioid and benzodiazepine use (15.9% of veterans with PTSD).
Conclusions:
- Findings highlight the complexity of managing overlapping symptoms in veterans with PTSD using sedative medications.
- Emphasizes the need for comprehensive treatment approaches, including non-pharmacologic options, to address co-occurring conditions.
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