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Trends in hypnotic drug use in depression 2007-2017: A Swedish population-based study
Adam Nygren1, P Brenner1,2, L Brandt1
1Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden.
Journal of Sleep Research
|June 14, 2024
Summary
Hypnotic drug use in depression patients remained high between 2007-2017, with Z-drug prescriptions declining and melatonin use increasing significantly. This trend persisted even three years post-diagnosis.
Area of Science:
- Pharmacology
- Psychiatry
- Public Health
Background:
- Insomnia is a frequent symptom of depression, yet treatment guidelines offer limited guidance on hypnotic medication.
- Research on hypnotic drug use in depression patients is scarce.
Purpose of the Study:
- To investigate the prevalence and trends of hypnotic drug use in patients diagnosed with unipolar depression in Sweden from 2007 to 2017.
Main Methods:
- A cohort study utilizing national Swedish registers, including 222,077 patients aged 18+ with incident unipolar depression.
- Follow-up for 3 years, analyzing annual and quarterly hypnotic drug prescription fills.
- Prevalence ratios (PR) were calculated to compare 2017 with 2007.
Main Results:
- In the year post-diagnosis, hypnotic use was 44.1% in 2017 vs. 46.7% in 2007 (PR 0.94).
- Z-drug prevalence decreased from 35.6% (2007) to 27.6% (2017) (PR 0.78), while melatonin use surged from 0.4% to 12.0% (PR 28.9).
- Hypnotic use was highest early post-diagnosis but remained at 19.2% after 3 years; higher use was observed in women, older patients, and those with comorbidities or severe depression.
Conclusions:
- Hypnotic medications are widely used in depression care in Sweden.
- A notable shift occurred from Z-drugs to melatonin, with melatonin use increasing dramatically.
- Sustained hypnotic drug use, even long-term, highlights a significant clinical issue in depression management.
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