Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample

Takayanagi, Yoichiro; Spira, Adam P.; Bienvenu, O. Joseph; Hock, Rebecca S.; Carras, Michelle Colder; Eaton, William W.; Mojtabai, Ramin

doi:10.4088/jcp.13m08824

Cited by 34 publications

(17 citation statements)

References 33 publications

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“…In socioeconomic terms, the typical patient taking psychotropic drugs is a woman aged ≥45 years. A significant association has been found between this profile and psychotropic drug use, consistent with findings from studies such as the Baltimore Epidemiologic Catchment Area (ECA) Study [25], which shows ≥45 years to be the age group with the highest prevalence of behavioral disorders in women, or the Swedish Women’s Health in Lund Area Study (WHILA) (Study [26], which was performed to determine the prevalence of psychotropic drug use in middle-aged women and to examine the association with various social factors and health profiles.…”

Section: Discussionsupporting

confidence: 80%

Time Trend in Psychotropic Medication Use in Spain: A Nationwide Population-Based Study

Carrasco‐Garrido

Hernández-Barrera

Trujillo

et al. 2016

IJERPH

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Background: We performed an epidemiologic study to analyze nationwide time trends in adult psychotropic drug use over a period from 2006 to 2012, and to identify those factors associated with the likelihood of consumption of these drugs during the study period; Methods: Cross-sectional study on psychotropic medication in the Spanish adult population. We used secondary individualized data drawn from the 2006 and 2012 Spanish National Health Surveys (SNHS). The dependent variable was the use of psychotropic drugs in the previous two weeks. Independent variables included socio-demographic characteristics, comorbidity, lifestyles and healthcare resource utilization. Using logistic multivariate regression models, we analyzed the temporal evolution of psychotropic medication consumption between 2006 and 2012 in both sexes; Results: The prevalence of psychotropic drug use was significantly greater in women (18.14% vs. 8.08% in 2012 (p < 0.05). In Spanish women, the variables associated with a greater probability of psychotropic use were, age, unemployment (adjusted odds ratio (AOR), 1.60; 95% CI, 1.24–2.07), negative perception of health or taking non-psychotropic drugs. Among men, psychotropic use is associated with presence of chronic disease, negative perception of health (AOR, 3.27; 95% CI, 2.62–4.07 in 2012) or inactive status; Conclusions: Between 2006 and 2012, the probability of having taken psychotropic drugs increased by 16% among women. Unemployed women aged ≥45 years with a negative perception of their health constitute a clear risk profile in terms of psychotropic drug use. Inactive men who have a negative perception of their health are the group most likely to consume psychotropic drugs.

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Section: Discussionsupporting

confidence: 80%

Time Trend in Psychotropic Medication Use in Spain: A Nationwide Population-Based Study

Carrasco‐Garrido

Hernández-Barrera

Trujillo

et al. 2016

IJERPH

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“…2 Finally, visit diagnoses are limited to three, so prescribing without a diagnosis may be overestimated. However, psychotropic use without a diagnosis has been described in other data 6 so is unlikely an artifact of NAMCS.…”

Section: Discussionmentioning

confidence: 83%

Trends in Central Nervous System–Active Polypharmacy Among Older Adults Seen in Outpatient Care in the United States

et al. 2017

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With each new revision of the Beers Criteria, the list of psychotropic medications considered potentially inappropriate in the elderly has grown. Opioids have recently been included in a Beers measure of central nervous system (CNS) polypharmacy. 1 Prescribing related drug combinations also received increased regulatory attention when the US Food and Drug Administration recently ordered a black-box warning to alert patients of serious risks, including death, caused by opioids coprescribed with CNS depressants. While evidence builds concerning harms of CNS polypharmacy, little is known about the trends in relevant prescribing practices.

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“…First, it may reflect expanding use of psychotropic medication beyond that for specific mental health diagnoses: the clinical subpopulation for which use of all medication groups increased was in those without any mental health or pain diagnosis. While prior work has demonstrated use of psychotropic medication in the absence of clearly defined mental disorders, 20,21,40–42 this is the first to demonstrate that such use has increased over time in the U.S. In a recent analysis of the Health and Retirement Study, Soldo et al found that, relative to previous cohorts, Baby Boomers approaching retirement reported they have “more difficulty with a range of everyday physical tasks, [but also report] more pain, more chronic conditions, [and] more drinking and psychiatric problems.” 43 In light of this work, a possible interpretation of our results is that newer cohorts of older adults have additional aging-associated distress, leading to increased non-specific use of psychotropic medication in an attempt to address these concerns.…”

Section: Discussionmentioning

confidence: 99%

National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care

Maust¹,

Blow²,

Wiechers³

et al. 2017

J. Clin. Psychiatry

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Objective To describe how use of antidepressants, benzodiazepines, and other anxiolytic/sedative-hypnotics among older adults (age ≥65) has changed over time among visits to primary care providers and psychiatrists in the United States. Method Data came from the National Ambulatory Medical Care Survey (years 2003–2005 and 2010–2012), a nationally-representative cross-section of outpatient physician visits. Analysis focused on visits to primary care providers (n=14,282) and psychiatrists (n=1,095) at which an antidepressant, benzodiazepine, or other anxiolytic/sedative-hypnotic was prescribed, which were stratified by demographic and clinical characteristic (including ICD-9-CM diagnosis) and compared across study intervals. Odds of medication use were calculated for each stratum, adjusting for demographic and clinical characteristics. Results The visit rate by older adults to primary care providers where any of the medications were prescribed rose from 16.4% to 21.8% (AOR 1.43, p<0.001), while remaining steady among psychiatrists (75.4% v. 68.5%; AOR 0.69, p=0.11). Primary care visits rose for antidepressants (9.9% to 12.3%; AOR 1.28, p=0.01) and other anxiolytic/sedative-hypnotics (3.4% to 4.7%; AOR 1.39, p=0.01), but the largest growth was among benzodiazepines (5.6% to 8.7%; AOR 1.62, p<0.001). Among patients in primary care, increases primarily occurred among men, non-Hispanic white patients, and both those with pain diagnoses as well as those without any mental health or pain diagnoses. Conclusion From 2003–2012, use of the most common psychotropic medications among older adults seen in primary care increased, concentrated among patients with no mental health or pain diagnosis. As the population of older adults grows and receives mental health treatment in primary care, it is critical to examine the appropriateness of psychotropic use.

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Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample

Cited by 34 publications

References 33 publications

Time Trend in Psychotropic Medication Use in Spain: A Nationwide Population-Based Study

Time Trend in Psychotropic Medication Use in Spain: A Nationwide Population-Based Study

Trends in Central Nervous System–Active Polypharmacy Among Older Adults Seen in Outpatient Care in the United States

National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care

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