Concomitant use of anxiolytics and hypnotics with selective serotonin reuptake inhibitors

A retrospective drug utilization analysis was conducted to compare concomitant use of anxiolytics and hypnotics among patients who received selective serotonin reuptake inhibitors (SSRIs). Data were extracted from an administrative prescription claims database. Patients must have been 18 to 64 years of age, without antidepressant, anxiolytic, or hypnotic use before SSRI therapy initiation, and without the use of antidepressants, other than the original SSRI, after SSRI therapy initiation. The study sample included 117,319 patients. Concomitant anxiolytic use for the total sample was 9.8%. Concomitant anxiolytic use rates for the comparison groups were: fluoxetine, 9.5%; paroxetine, 11.4%; and sertraline, 9.5%. Concomitant hypnotic use for the total sample was 2.8%. Concomitant hypnotic use rates for the comparison groups were: fluoxetine, 2.5%; paroxetine, 3.5%; and sertraline, 2.8%. The majority of concomitant anxiolytic and hypnotic use was initiated on the same day as SSRI therapy initiation. The anxiolytic and hypnotic concomitant use rates for fluoxetine and sertraline patients were significantly lower than the concomitant use rates for paroxetine patients. An understanding of the clinical, quality-of-life, and economic implications of the concomitant use differences will require further study.