Are we going to increase the use of antidepressants up to that of benzodiazepines?

Ciuna, Arcangelo; Andretta, Margherita; Corbari, Letizia; Levi, Deborah; Mirandola, Mersia; Sorio, Adriano; Barbui, Corrado

doi:10.1007/s00228-004-0810-8

Cited by 74 publications

(41 citation statements)

References 15 publications

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“…In an earlier national Italian study (1992)(1993), the prevalence of benzodiazepine use was found to be 8.6% in 1993 and doses to be 49.4 DDD/1,000 inhabitants/day in 1991; 28 benzodiazepines were available (60 brands and 133 products) [35] . Another Italian national study found benzodiazepine use to be stable with 50 DDD/1,000 inhabitants/day from 1995 to 2003 as compared to the marked increase in DDDs for SSRI antidepressants [36] . In Switzerland ( table 4 ) with 17 different benzodiazepines available in 2002, 43.3 DDD/1,000 inhabitants/day are reported with a 6-month prevalence of 9.1% [37] .…”

Section: Discussionmentioning

confidence: 99%

Hypnotics and Triazolobenzodiazepines - Best Predictors of High-Dose Benzodiazepine Use: Results from the Luxembourg National Health Insurance Registry

Cloos¹,

Bocquet

Rolland-Portal³

et al. 2015

Psychother Psychosom

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Background: Benzodiazepines are not all the same concerning their risk of high-dose use. Methods: We studied benzodiazepine use from the Luxembourg national records of all insured. We calculated the 12-year prevalence from 1995 to 2007. Benzodiazepine users were divided into 3 groups, short-term with no longer than 3-month intake, intermediate with multiple administration with at least a 1-year interruption, and continuous who never stopped. A high-dose user (HDU) was defined as a patient who received a higher dose than the yearly maximum usual therapeutic dose. Results: An average of 16.0% of the adult insured population received at least 1 benzodiazepine annually, 42.9% were older than 50, 55.9% were women, and 5.4% were HDUs. We found that 32.6% were short-term users, 49.0% intermediate and 18.4% continuous. Compared to diazepam, hypnotics had higher risks for high-dose use in at least 1 age group at first-benzodiazepine intake, the risks being greater in elderly subjects and women, the highest risks being with triazolam (adjusted odds ratio = 215.85; 95% confidence interval = 133.75-348.35) in the 69- to 105-year-old group at first-benzodiazepine intake. Anxiolytics had a low risk except for alprazolam and prazepam in the 69- to 105-year-old group at first-benzodiazepine intake, clonazepam and clobazam had the lowest risk in 18- to 43-year-olds at first-benzodiazepine intake. Alprazolam had dispensed volumes increased by threefold over the 12-year period. Conclusion: All hypnotics had higher risks for high-dose use compared to diazepam in continuous users. Two anxiolytics, clonazepam and clobazam, had the lowest risks. Hypnotics and the triazolobenzodiazepines alprazolam and triazolam were most problematic. Elderly subjects and women are at greater risks.

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Section: Discussionmentioning

confidence: 99%

Hypnotics and Triazolobenzodiazepines - Best Predictors of High-Dose Benzodiazepine Use: Results from the Luxembourg National Health Insurance Registry

Cloos¹,

Bocquet

Rolland-Portal³

et al. 2015

Psychother Psychosom

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“…2 Studies conducted in Chile, Italy and Spain have revealed prevalence of use of between 4 and 7.5% over the past 12 months. [3][4][5] A fi gure of 10.2% has been found for the city of São Paulo, Brazil. 6 A higher rate of 21.3% has been found in Porto Alegre, in southern Brazil.…”

Section: Introductionmentioning

confidence: 99%

Chronic use of diazepam in primary healthcare centers: user profile and usage pattern

et al. 2007

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CONTEXT AND OBJECTIVE: Chronic use of benzodiazepines is frequent in general practice. The aim of this study was to describe the usage pattern and profile of chronic users of diazepam who had been consuming this drug for a minimum of thirty-six months continuously. DESIGN AND SETTING: This was a descriptive study (survey and clinical assessment) at five primary healthcare centers in Campinas, Brazil. METHODS: Psychotropic drug control books revealed 48 eligible patients. Among these, 41 were assessed by means of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), the Hospital Anxiety and Depression scale (HAD) and a questionnaire on usage pattern. RESULTS: Most patients were women (85.4%). The patients' mean age was 57.6 years, and they were from the social strata C (39%), D (54%) and E (7%). The mean length of diazepam consumption was 10 years. The patients presented a lack of prescription compliance and had made frustrated attempts to stop using the drug. 55.5% said their doctor had never given any guidance on the effects of the drug. According to SCAN, 25 patients (61%) suffered from depressive disorders; only 12 cases of benzodiazepine dependence were detected by this instrument. CONCLUSION: There is a need to improve the detection and treatment of mental disorders, as well as to prevent inappropriate prescription and use of benzodiazepines. Diazepam dependence has distinctive characteristics that make it undetected by SCAN.

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“…Venlafaxine is capable of inhibiting central serotonin and norepinephrine neuronal reuptake, and has increasingly been used in the treatment of depression and anxiety disorder (Holliday and Benfield, 1995;Ciuna et al, 2004). It is associated with a number of predictable adverse effects that are generally mild, including tachycardia, increased blood pressure, fatigue, headache, dizziness, sexual dysfunction, and dry mouth (Johnson et al, 2006;Stahl et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Venlafaxine Ingestion Is Associated With Rhabdomyolysis in Adults: A Case Series

2007

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-Rhabdomyolysis has been reported after venlafaxine ingestion. We wished to characterize the prevalence of this adverse effect in a realistic clinical setting. Therefore, a retrospective casenote review was performed, including 235 patients admitted to the Royal Infirmary of Edinburgh due to venlafaxine overdose between January 2000 and June 2006. Seizures occurred in 8.9% of the study population. Patients who suffered seizures had ingested larger quantities of venlafaxine than those who did not develop seizures; median (interquartile range) 2800 mg (2006-4350 mg) versus 1500 mg (900-2700 mg, p = 0.001). Raised CK values were more prevalent in those with seizures than those without seizures (61.1% versus 25.7% respectively, p = 0.004). Nonetheless, a positive correlation was found between the quantity of venlafaxine ingested and CK across the whole group (rho = 0.201, 95% confidence interval 0.045-0.347), and in patients who had not developed seizures (rho = 0.174, 95% confidence interval 0.009-0.331). Venlafaxine overdose is associated with a high prevalence of acute muscle injury, both in patients who develop seizures and in those who do not. The clinical significance of this association merits further consideration.

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Are we going to increase the use of antidepressants up to that of benzodiazepines?

Abstract: In Italy, the consumption of benzodiazepines was not affected by the increased prescribing of selective serotonin-reuptake inhibitors and newer antidepressants.

Cited by 74 publications

References 15 publications

Hypnotics and Triazolobenzodiazepines - Best Predictors of High-Dose Benzodiazepine Use: Results from the Luxembourg National Health Insurance Registry

Hypnotics and Triazolobenzodiazepines - Best Predictors of High-Dose Benzodiazepine Use: Results from the Luxembourg National Health Insurance Registry

Chronic use of diazepam in primary healthcare centers: user profile and usage pattern

Venlafaxine Ingestion Is Associated With Rhabdomyolysis in Adults: A Case Series

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