The Utilization of Antidepressants and Benzodiazepines among People with Major Depression in Canada

Abstract

A large proportion of people with past-year MDEs utilized ADs and BDZs. It is unclear how much of this is appropriate given that evidence-based clinical guidelines recommend monotherapy with ADs in the treatment of major depression.

Factors Associated with the Combined Use of Antidepressants and Benzodiazepines in Major Depression: A Case–Control Study

“…It was observed that patients age older than 35 years were more likely to engage in combined use, which is similar to the results found by other researchers . Furthermore, the Diagnostic and Statistical Manual of Mental Disorders reports that major depression usually appears after 25 years of age .…”

“…Anxiety presents as a comorbidity in 33–85% of patients with major depression . Therefore, combined prescriptions of antidepressants plus benzodiazepines (BDZs) are common . A meta‐analysis involving ten randomized, clinical trials showed that the combined use of antidepressants and BDZs reduced the severity of depression symptoms by more than 50% and resulted in a lower drop‐out rate until the fourth week of treatment than the group treated with antidepressants alone.…”

“…Research conducted in the United States, Canada, Spain and China has shown that there have been failures to withdraw from BDZs during antidepressant therapy because most depressed patients remained under long‐term combined treatment with antidepressants and BDZs . In other contexts, such as in the Middle East, BDZs are not recommended to treat major depression .…”

Trends in Psychotropic Use in Saskatchewan from 1983 to 2007

“…Epidemiologic studies have reported trends in APs, ADs, and polypharmacy among general populations or subgroups (that is, adolescents). 8,[14][15][16] [3][4][5]19 Directly comparing the prevalence of psychotropic use reported in our study with the literature is difficult because studies have been carried out at different times and there has been increases in the use of psychotropics over time.…”

“…6 In a US national study 7 the number of polypharmacy psychotropics prescribed has significantly increased from 1996 to 2007. Sanyal et al, 8 analyzing the national Canadian survey data, found that 49.3% of respondents with past-year major depression used ADs and benzodiazepines in 2002. There was a decline in the use of selective serotonin reuptake inhibitors from 1996 to 2009 in the province of Manitoba as a result of the introduction of generic versions.…”