Abstract
BACKGROUND: Antidepressant prescribing has dramatically increased in Scotland, and the cause is unknown.
OBJECTIVE: To investigate if the increase in antidepressant prescribing coincided with a reduction in prescribing of anxiolytics and hypnotics; to investigate this relationship at practice level; and to explore whether general practitioners (GPs) explain the increase by their increased use for anxiety.
METHODS: Study design: analysis of routine prescribing data and interviews with GPs.
SETTING: Scottish general practices.
PARTICIPANTS: 942 practices included in the analysis. Sixty-three GPs in 30 practices completed interviews. Main outcome measures: Quantity of antidepressants, anxiolytics, and hypnotics prescribed. Relationship at practice level between anxiolytic/hypnotic and antidepressant prescribing. Spontaneous comments by GPs about prescribing antidepressants for anxiety.
RESULTS: Antidepressant prescribing increased from 28.9 million defined daily doses (DDDs) in 1992/3 to 128.3 million in 2004/5. Anxiolytic/hypnotic prescribing fell from 64.2 million to 55.1 million DDDs. There was a weak, positive correlation between levels of antidepressant and anxiolytic/hypnotic prescribing (+0.084, p=0.010). GPs treated anxiety with antidepressants, although many described an overlap between anxiety and depression. Some spontaneously identified a relationship with benzodiazepine prescribing when asked to explain the increase in antidepressant prescribing.
CONCLUSION: A small part of the increase in antidepressant prescribing is due to substitution for benzodiazepines to treat anxiety.
OBJECTIVE: To investigate if the increase in antidepressant prescribing coincided with a reduction in prescribing of anxiolytics and hypnotics; to investigate this relationship at practice level; and to explore whether general practitioners (GPs) explain the increase by their increased use for anxiety.
METHODS: Study design: analysis of routine prescribing data and interviews with GPs.
SETTING: Scottish general practices.
PARTICIPANTS: 942 practices included in the analysis. Sixty-three GPs in 30 practices completed interviews. Main outcome measures: Quantity of antidepressants, anxiolytics, and hypnotics prescribed. Relationship at practice level between anxiolytic/hypnotic and antidepressant prescribing. Spontaneous comments by GPs about prescribing antidepressants for anxiety.
RESULTS: Antidepressant prescribing increased from 28.9 million defined daily doses (DDDs) in 1992/3 to 128.3 million in 2004/5. Anxiolytic/hypnotic prescribing fell from 64.2 million to 55.1 million DDDs. There was a weak, positive correlation between levels of antidepressant and anxiolytic/hypnotic prescribing (+0.084, p=0.010). GPs treated anxiety with antidepressants, although many described an overlap between anxiety and depression. Some spontaneously identified a relationship with benzodiazepine prescribing when asked to explain the increase in antidepressant prescribing.
CONCLUSION: A small part of the increase in antidepressant prescribing is due to substitution for benzodiazepines to treat anxiety.
| Original language | English |
|---|---|
| Pages (from-to) | 129-135 |
| Number of pages | 7 |
| Journal | European Journal of General Practice |
| Volume | 14 |
| Issue number | 3-4 |
| DOIs | |
| Publication status | Published - 2008 |
Keywords
- general practice
- primary care
- prescribing
- antidepressants
- depression
- anxiety