Trends in the Use of Benzodiazepines, Z-Hypnotics, and Serotonergic Drugs Among US Women and Men Before and During the COVID-19 Pandemic

Milani, Sadaf Arefi; Raji, Mukaila; Lu, Ciyong; Kuo, Yong‐Fang

doi:10.1001/jamanetworkopen.2021.31012

Cited by 71 publications

(49 citation statements)

References 26 publications

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“…Second, the observed prevalence of antidepressant use in our cohort (2%) was similar to pre-pandemic estimates, despite the high prevalence of depressive symptoms in this cohort during the study period [10,25]. This finding is in contrast with recent studies in non-perinatal samples showing increased exposure to antidepressants and psychotropics during the pandemic [22][23][24]. The low rate of antidepressant and psychotropic use in our cohort compared to the high prevalence of mental distress might have been caused by limited or delayed diagnosis of depression or anxiety by HCPs.…”

Section: Main Findingssupporting

confidence: 64%

“…Examples of this include the publication of premature assumptions on the beneficial or detrimental effects of medications on COVID-19 outcomes (e.g., hydroxychloroquine, non-steroidal anti-inflammatory drugs) [17,18]. Other publications have shown that some medications have been used or dispensed to a lesser extent within the general public (i.e., antibiotics, insulin) [19][20][21], whereas other medications have been prescribed or dispensed more often (i.e., psychotropics and antidepressants) [22][23][24]. However, the extent to which this phenomenon is applicable to pregnant and breastfeeding women remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Self-Reported Medication Use among Pregnant and Breastfeeding Women during the COVID-19 Pandemic: A Cross-Sectional Study in Five European Countries

Ceulemans

Foulon

Panchaud

et al. 2022

IJERPH

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Insight into the epidemiology of perinatal medication use during the COVID-19 pandemic is scarce. Therefore, a cross-sectional study using an anonymous web survey was performed in Ireland, Norway, Switzerland, the Netherlands, and United Kingdom (UK) to investigate the prevalence and type of medications used by pregnant and breast-feeding women during the first pandemic wave. Factors associated with medication use were estimated by logistic regression. In total, 8378 women participated (i.e., 3666 pregnant and 4712 breastfeeding women). Most responses were collected in Norway (34%) and the Netherlands (28%), followed by Switzerland (19%), Ireland (17%) and UK (2%). Participants were more often professionally active and more often had a higher educational level compared to the general birthing population in each country. Overall, approximately 60% of women reported having used at least 1 medication in the preceding 3 months. Daily and occasional use was reported by 34% and 42% of pregnant and 29% and 44% of breastfeeding women. The most prevalent ATC (Anatomical Therapeutic Chemical) categories were the nervous system, the respiratory system, the alimentary tract/metabolism, and the musculo-skeletal system. Paracetamol, ibuprofen, antacids, and cetirizine were the most frequently used medications. The rate of antibacterial use was lower than previously reported. Having a chronic illness, country, maternal age, SARS-CoV-2 testing, professional status and time since delivery were associated with medication use. In conclusion, perinatal medication use was highly prevalent during the first pandemic wave, underlining the importance of maintaining counseling efforts on medication use, even in times of disrupted healthcare services and/or limited resources.

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Section: Main Findingssupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Self-Reported Medication Use among Pregnant and Breastfeeding Women during the COVID-19 Pandemic: A Cross-Sectional Study in Five European Countries

Ceulemans

Foulon

Panchaud

et al. 2022

IJERPH

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“…Previous studies already investigated the impact of lockdown on antidepressant drug (AD) use. In particular, some studies reported an increased use of these medications during the first wave [15,16] that in some case persist also during the subsequent period of 2020 [17][18][19][20]. On the contrary, other studies found an initial reduction of AD use during the peak of the first wave followed by an increased use in the subsequent periods [21].…”

Section: Introductionmentioning

confidence: 99%

Antidepressants Drug Use during COVID-19 Waves in the Tuscan General Population: An Interrupted Time-Series Analysis

Antonazzo

Fornari

Maumus-Robert

et al. 2022

JPM

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In Italy, during the COVID-19 waves two lockdowns were implemented to prevent virus diffusion in the general population. Data on antidepressant (AD) use in these periods are still scarce. This study aimed at exploring the impact of COVID-19 lockdowns on prevalence and incidence of antidepressant drug use in the general population. A population-based study using the healthcare administrative database of Tuscany was performed. We selected a dynamic cohort of subjects with at least one ADs dispensing from 1 January 2018 to 27 December 2020. The weekly prevalence and incidence of drug use were estimated across different segments: pre-lockdown (1 January 2018–8 March 2020), first lockdown (9 March 2020–15 June 2020), post-first lockdown (16 June 2020–15 November 2020) and second lockdown (16 November 2020–27 December 2020). An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes. Compared to the pre-lockdown we observed an abrupt reduction of ADs incidence (Incidence-Ratio: 0.82; 95% Confidence-Intervals: 0.74–0.91) and a slight weekly decrease of prevalence (Prevalence-Ratio: 0.997; 0.996–0.999). During the post-first lockdown AD use increased, with higher incidence- and similar prevalence values compared with those expected in the absence of the outbreak. This pandemic has impacted AD drug use in the general population with potential rebound effects during the period between waves. This calls for future studies aimed at exploring the mid–long term effects of this phenomenon.

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“…Overall, the need for safe and effective detoxification protocols from sedative-hypnotic medications has increased as the availability both via prescription and illicit markets has increased dramatically in recent years [ 3 ]. The COVID-19 pandemic only compounded this as rates of BZD prescriptions increased during this period and continue to remain elevated [ 4 ]. For the above reasons, discontinuing sedative-hypnotic medications should be considered after prolonged use, especially if used improperly or abused [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Phenobarbital use in benzodiazepine and z-drug detoxification: a single-centre 15-year observational retrospective study in clinical practice

Sartori,

Crescioli,

Brilli

et al. 2022

Intern Emerg Med

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Given the increase in benzodiazepine (BZD) and Z-drug (ZD) use disorder, this study described the use of phenobarbital (PHB) as detoxification in clinical practice. A 15-year observational retrospective study was performed on medical records of BZD-ZD use disorder patients detoxified with PHB at the Toxicology Unit and Poison Centre, Careggi University Hospital, Florence (Italy). A multivariate logistic regression was used to estimate odd ratios (ORs) and related 95% confidence intervals (CI) of “treatment failure” considering demographic and pharmacological characteristics. “Hospitalisation length”, “PHB discharge dose”, and “BZD-ZD free status” at discharge were also calculated. During detoxification, out of 355 patients (57% of men), with a mean age of 42.92 years, only 20 (5.6%) treatment failures were recorded: 19 were discharged against medical advice or due to misbehaviour, and only one for PHB-related non-serious skin rash. Analysis showed a higher probability to be BZD-ZD free at discharge for subjects who reported to be employed (OR 2.29; CI 95% 1.00–5.24), for those who abused oral drops of BZD-ZD (OR 2.16, CI 1.30–3.59), and for those treated with trazodone (OR 2.86, CI 1.14–7.17) during hospital stay. A hospitalisation length of > 7 days was observed for patients with opioid maintenance therapy (OR 2.07, CI 1.20–3.58) for substance use disorder, and for those treated with more than 300 mg/day of PHB equivalents at hospital admission (OR 1.68, CI 1.03–2.72). Our results suggested that PHB can be considered a valuable detoxification option for different types of BZD and ZD use disorder patients.

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Trends in the Use of Benzodiazepines, Z-Hypnotics, and Serotonergic Drugs Among US Women and Men Before and During the COVID-19 Pandemic

Cited by 71 publications

References 26 publications

Self-Reported Medication Use among Pregnant and Breastfeeding Women during the COVID-19 Pandemic: A Cross-Sectional Study in Five European Countries

Self-Reported Medication Use among Pregnant and Breastfeeding Women during the COVID-19 Pandemic: A Cross-Sectional Study in Five European Countries

Antidepressants Drug Use during COVID-19 Waves in the Tuscan General Population: An Interrupted Time-Series Analysis

Phenobarbital use in benzodiazepine and z-drug detoxification: a single-centre 15-year observational retrospective study in clinical practice

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