Trends in psychotropic drug consumption among French military personnel during the COVID-19 epidemic

Abstract

Background The coronavirus disease (COVID-19) pandemic may have had significant mental health consequences for military personnel, which is a population already exposed to psychological stress. To assess the potential impact of the COVID-19 pandemic, we analyzed the dispensing of three classes of psychotropic drugs (anxiolytics, hypnotics, and antidepressants) among French military personnel. Methods A retrospective analysis was conducted using the individualized medico-administrative data of persons insured by the National Military Social Security Fund from the National Health Data System. All active French military personnel aged 18–64 who received outpatient care and to whom drugs were dispensed between January 1, 2019, and April 30, 2021, were included from the French national health database. Rate ratios of dispensed anxiolytics, hypnotics and antidepressants (based on drug reimbursement) were estimated from negative binomial regressions before and after the start of the COVID-19 pandemic. Results Three hundred eighty-one thousand seven hundred eleven individuals were included. Overall, 45,148 military personnel were reimbursed for anxiolytics, 10,637 for hypnotics, and 4328 for antidepressants. Drugs were dispensed at a higher rate in 2020 and 2021 than in 2019. There was a notable peak at the beginning of the first lockdown followed by a decrease limited to the duration of the first lockdown. During the first lockdown only, there were temporary phenomena including a brief increase in drug dispensing during the first week followed by a decrease during the rest of lockdown, possibly corresponding to a stocking-up effect. For the study period overall, while there was a significant downward trend in psychotropic drug dispensing before the occurrence of COVID-19 (p < 0.001), the pandemic period was associated with an increase in dispensed anxiolytics (rate ratio, 1.03; 95% CI, 1.02–1.04, p < 0.05), hypnotics (rate ratio, 1.13; 95% CI, 1.11–1.16, p < 0.001) and antidepressants (rate ratio, 1.12; 95% CI, 1.10–1.13, p < 0.001) in the military population. Conclusions The COVID-19 pandemic has probably had a significant impact on the mental health of French military personnel, as suggested by the trends in dispensed psychotropic drugs. The implementation of mental health prevention measures should be investigated for this population.

Prolonged increase in psychotropic drug use among young women following the COVID-19 pandemic: a French nationwide retrospective study

“…This decrease may be linked to an important prevention campaign conducted in France to limit the prescription of psychotropic drugs [ 20 ]. During the pandemic, there was an immediate increase in the number of people using anxiolytics, hypnotics, and antidepressants, which is consistent with the previous studies on consumption during the pandemic [ 9 , 13 – 20 , 22 ] and could reinforce the reported impact of lockdowns on mental health [ 6 , 8 ]. Post-pandemic, anxiolytic and hypnotic use decreased, while antidepressant consumption continued to rise.…”

“…Several studies examined the prescription of psychotropic drugs during the COVID-19 pandemic and observed an increase in the consumption of anxiolytics, hypnotics, and antidepressants in 2020 compared to 2019 [ 14 – 19 ]. In France, similar studies have been conducted using national databases [ 9 , 20 , 21 ], regional [ 13 ] or national military samples [ 22 ]. As in other countries, these studies revealed an increase in psychotropic drug consumption during the pandemic period, particularly notable among young people [ 9 , 13 , 18 , 19 , 23 ] and women [ 13 , 19 , 23 ].…”

Impact of COVID-19 epidemic on antihypertensive drug treatment disruptions: results from a nationwide interrupted time-series analysis

“…The epidemic of COVID-19 has disrupted the management of patients: overcrowding of emergency services, long and repeated lockdowns (Cauchemez et al, 2020;Spaccaferri et al, 2020;Cransac-Miet et al, 2021), stress induced by the spread of the virus (Moreno et al, 2020;Salari et al, 2020). Like others, we have previously highlighted that in France, the first lockdown led to prescription stoppages (Levaillant et al, 2021;Mathieu et al, 2022;Sanchez et al, 2022) and was accompanied by an excess of cardiovascular drug treatment shortages (Mathieu et al, 2022). In addition, we were concerned that the COVID-19 epidemic may have had a more profound impact on cardiovascular treatment disruptions, either by worsening their characteristics or by causing them in patients who would usually have been at lower risk.…”

“…This study focuses on a topic that is not widely discussed in the literature yet. However, if the impact of the COVID-19 epidemic on interruptions of antihypertensive treatment has been little assessed, several studies have shown a worrying decrease in the use of chronic drugs over the pandemic, in fields as various as mental disorders ( Mansfield et al, 2021 ; Sanchez et al, 2022 ) or diabetes for instance ( Corral-Partearroyo et al, 2022 ; Mathieu et al, 2022 ). Considering more specifically cardiovascular drugs, our results appear consistent with those of a study assessing the impact of the epidemic on adherence to statins ( Malo et al, 2022 ).…”

Sales trends of psychotropic drugs in the COVID-19 pandemic: A national database study in Brazil

“…Recent studies in several countries around the world are unanimous in showing a significant increase in the consumption of psychotropic drugs during the period of the COVID-19 pandemic. Studies from Canada (Ying et al, 2023), France (Benistand et al, 2022;Sanchez et al, 2022), Portugal (Estrela et al, 2022), Scandinavia (Tiger et al, 2023), United States (Amill-Rosario et al, 2022), Danish (Bliddal et al, 2023) showed that the effects of the pandemic were not restricted to the infectivity and pathogenicity of the virus at the level of the respiratory system, but also left important psychological sequelae with increased used of psychotropic medications.…”