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

Morrison, J.M., Anderson, M.J., Macdonald, S. , Maxwell, M., Munoz-Arroyo, R., Power, A., Smith, M., Sutton, M. and Wilson, P. (2008) Relationship between antidepressant and anxiolytic/hypnotic prescribing: A mixed-methods study. European Journal of General Practice, 14(3-4), pp. 129-135. (doi: 10.1080/13814780802632683)

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wilson, Prof Philip and Smith, Dr Margaret and Macdonald, Professor Sara and Morrison, Professor Jill
• Authors: Morrison, J.M., Anderson, M.J., Macdonald, S., Maxwell, M., Munoz-Arroyo, R., Power, A., Smith, M., Sutton, M., and Wilson, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: European Journal of General Practice
• ISSN: 1381-4788
• ISSN (Online): 1751-1402