Relationship between antidepressant and anxiolytic/hypnotic prescribing: a mixed methods study

Jill Morrison, Mary-Jane Anderson, Sara Macdonald, Margaret Maxwell, Rosalia Munoz-Arroyo, Andrew Power, Michael Smith, Matthew Sutton, Philip Wilson

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)129-135
Number of pages7
JournalEuropean Journal of General Practice
Volume14
Issue number3-4
DOIs
Publication statusPublished - 2008

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Keywords

  • general practice
  • primary care
  • prescribing
  • antidepressants
  • depression
  • anxiety

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