Determinants of Coprescription of Anxiolytics with Antidepressants in General Practice

Verger, Pierre; Saliba, Bérengère; Rouillon, Frédéric; Kovess–Masféty, Viviane; Villani, Patrick; Bouvenot, G; Lovell, Anne M.

doi:10.1177/070674370805300204

Cited by 15 publications

(13 citation statements)

References 28 publications

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“…A high BZD prescription rate was also seen in a smaller French study [14] in which general practitioners completed consultation questionnaires for patients with an MDD diagnosis and then returned them (n ¼ 258). Sixty percent of the patients with MDD received BZDs with antidepressants.…”

Section: How Often and When Are Benzodiazepines Prescribed?mentioning

confidence: 73%

Current use of benzodiazepines in anxiety disorders

Cloos¹,

Ferreira²

2009

Current Opinion in Psychiatry

110

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Despite current guidelines, benzodiazepines are still considered by many clinicians to remain good treatment options, in both the acute and the chronic phase of the treatment of anxiety disorders, partially because of their rapid onset of action and their efficacy with a favourable side effect profile, and also because of the sometimes only incomplete therapeutic response and the emergence of side effects of alternative medications. Having experienced good initial symptom relief with benzodiazepine treatment, patients may also be reluctant to taper it down. Clinicians should, however, bear in mind the frequent physiological dependence associated with these substances, and suggest both pharmacological and psychological treatment alternatives before opting for a long-term benzodiazepine treatment, which may remain necessary in certain clinical conditions.

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Section: How Often and When Are Benzodiazepines Prescribed?mentioning

confidence: 73%

Current use of benzodiazepines in anxiety disorders

Cloos¹,

Ferreira²

2009

Current Opinion in Psychiatry

110

View full text Add to dashboard Cite

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“…3,39 A similar understanding of the dynamics of the GP consultation might explain lower prescribing levels by female GPs. Although previously reported findings lack consistency, 15,40 the link of female GPs with lower prescription rates could be attributed to the traditional consideration that female GPs are more psychosocially orientated and more patient-centred than their male colleagues. 41,42 Like others, 10 no evidence was found in the current study linking anxiolytic and hypnotic prescribing to the country where the GP qualified.…”

Section: Comparison With Existing Literaturementioning

confidence: 77%

Variations in anxiolytic and hypnotic prescribing by GPs: a cross-sectional analysis using data from the UK Quality and Outcomes Framework

2009

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“…It has been shown that patients initiating antidepressant treatment receive anxiolytic co-prescriptions at a rate that exceeds the rate of general use [25]. Co-prescription of psychotropic and other CNS-acting medications creates an especially high risk for drug-drug interactions in that these agents are often transported and metabolized by the same polymorphic enzymes.…”

Section: Discussionmentioning

confidence: 99%

Co-Prescription Trends in a Large Cohort of Subjects Predict Substantial Drug-Drug Interactions

et al. 2015

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Pharmaceutical prescribing and drug-drug interaction data underlie recommendations on drug combinations that should be avoided or closely monitored by prescribers. Because the number of patients taking multiple medications is increasing, a comprehensive view of prescribing patterns in patients is important to better assess real world pharmaceutical response and evaluate the potential for multi-drug interactions. We obtained self-reported prescription data from NHANES surveys between 1999 and 2010, and confirm the previously reported finding of increasing drug use in the elderly. We studied co-prescription drug trends by focusing on the 2009-2010 survey, which contains prescription data on 690 drugs used by 10,537 subjects. We found that medication profiles were unique for individuals aged 65 years or more, with ≥98 unique drug regimens encountered per 100 subjects taking 3 or more medications. When drugs were viewed by therapeutic class, it was found that the most commonly prescribed drugs were not the most commonly co-prescribed drugs for any of the 16 drug classes investigated. We cross-referenced these medication lists with drug interaction data from Drugs.com to evaluate the potential for drug interactions. The number of drug alerts rose proportionally with the number of co-prescribed medications, rising from 3.3 alerts for individuals prescribed 5 medications to 11.7 alerts for individuals prescribed 10 medications. We found 22% of elderly subjects taking both a substrate and inhibitor of a given cytochrome P450 enzyme, and 4% taking multiple inhibitors of the same enzyme simultaneously. By examining drug pairs prescribed in 0.1% of the population or more, we found low agreement between co-prescription rate and co-discussion in the literature. These data show that prescribing trends in treatment could drive a large extent of individual variability in drug response, and that current pairwise approaches to assessing drug-drug interactions may be inadequate for predicting real world outcomes.

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Determinants of Coprescription of Anxiolytics with Antidepressants in General Practice

Cited by 15 publications

References 28 publications

Current use of benzodiazepines in anxiety disorders

Current use of benzodiazepines in anxiety disorders

Variations in anxiolytic and hypnotic prescribing by GPs: a cross-sectional analysis using data from the UK Quality and Outcomes Framework

Co-Prescription Trends in a Large Cohort of Subjects Predict Substantial Drug-Drug Interactions

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