Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011

Stephenson, Chris P; Karanges, Emily A; McGregor, Iain S.

doi:10.1177/0004867412466595

Cited by 202 publications

(236 citation statements)

References 49 publications

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“…Approximately 8.7% of Australians and a similar proportion of Americans use antidepressant medications. 17,18 It was notable that a far higher proportion (51.8%) of our patients were on antidepressant therapy at baseline, consistent with their elevated PHQ-9 scores. It was also notable that with CPAP treatment the proportion of patients with symptoms of clinically significant depression decreased to below these proportions of people in the general community on antidepressant therapy.…”

Section: Depressive Symptoms Are Common Among People With Osasupporting

confidence: 60%

Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women

Edwards

Mukherjee

Simpson

et al. 2015

Journal of Clinical Sleep Medicine

116

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Study Objectives: To determine prevalence of depressive symptoms in obstructive sleep apnea (OSA) and the impact of OSA treatment on depression scores. Methods: Consecutive new patients referred for investigation of suspected OSA were approached. Consenting patients completed a patient health questionnaire (PHQ-9) for depressive symptoms when attending for laboratory polysomnography. Those with moderate/severe (apneahypopnea index [AHI] ≥ 15 events/h) and/or symptomatic mild OSA (AHI 5-14.99 events/h) were offered continuous positive airway pressure (CPAP) therapy. PHQ-9 was repeated after 3 months of CPAP with compliance recorded. Of a maximum PHQ-9 score of 27, a cut point ≥ 10 (PHQ-9 ≥ 10) was used to indicate presence of clinically signifi cant depressive symptoms. Results: A total of 426 participants (243 males) were recruited. Mean ± standard deviation body mass index (BMI) was 32.1 ± 7.1 kg/m 2 and AHI 33.6 ± 28.9 events/h. PHQ-9 was 10.5 ± 6.1 and independently related to AHI (p < 0.001) and BMI (p < 0.001). In those without OSA, PHQ-9 ≥ 10 was more common in women, but no gender difference was evident with OSA. Of 293 patients offered CPAP, 228 were compliant (mean nightly use > 5 h) over 3 months of therapy. In them, with therapy, AHI decreased from 46.7 ± 27.4 to 6.5 ± 1.6 events/h, PHQ-9 from 11.3 ± 6.1 to 3.7 ± 2.9 and PHQ-9 ≥ 10 from 74.6% to 3.9% (p < 0.001 in each case). Magnitude of change in PHQ-9 was similar in men and women. Antidepressant use was constant throughout. Conclusions: Depressive symptoms are common in OSA and related to its severity. They improve markedly with CPAP, implying a relationship to untreated OSA. Keywords: patient health questionnaire, depression, depressive symptoms, obstructive sleep apnea, continuous positive airway pressure. Citation: Edwards C, Mukherjee S, Simpson L, Palmer LJ, Almeida OP, Hillman DR. Depressive symptoms before and after treatment of obstructive sleep apnea in men and women. J Clin Sleep Med 2015;11(9):1029-1038.pii: jc-00354-14 http://dx.doi.org/10.5664/jcsm.5020 P ersistent sleep loss causes symptoms that are similar to those of depression, in part because frontal lobe centers responsible for emotional modulation are sensitive to disturbed sleep.1 Consistent with this observation, obstructive sleep apnea (OSA), a condition characterized by fragmented sleep, is commonly associated with depressive symptoms.2 Conversely, depression is often associated with disturbed sleep. Further, depression and OSA are prevalent in the community and, hence, could be expected to coexist in a signifi cant proportion of patients. The multidirectional relationships between depression, disturbed sleep, and OSA are a source of potential diagnostic confusion, which may explain why OSA, a generally under-recognized condition, is particularly under-diagnosed among people with depression.3 Failure to recognize and treat OSA in depressed patients may lead to inappropriate prescription of antidepressant therapy and/or persistence of depressive symptoms despite such therapy....

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Section: Depressive Symptoms Are Common Among People With Osasupporting

confidence: 60%

Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women

Edwards

Mukherjee

Simpson

et al. 2015

Journal of Clinical Sleep Medicine

116

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“…The increase in psychotropic drug prescriptions and the controversies surrounding their efficacy and tolerability have drawn the attention of health care researchers 2,3 . The elderly individuals, in special, are the most frequent users of psychotropic drugs, due to this population's prevalence of psychiatric comorbidities and the use of these drugs in relieving somatic conditions 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Uso de psicofármacos entre idosos residentes em comunidade: prevalência e fatores associados

Abi-Ackel

Lima‐Costa

Castro-Costa

et al. 2017

Rev. bras. epidemiol.

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ABSTRACT:Objective: Investigating the prevalence of psychotropic drug use among older adults and factors associated with it. Methods: This study was based on the Belo Horizonte Metropolitan Area Health Survey, conducted in 2003. It involved 1,635 elderly (60 years or older) citizens, who were residents of cities within the Belo Horizonte Metropolitan Area and were selected using complex randomize sampling. Logistic regression models were used to identify factors associated with psychotropic drug use, with a 5.0% significance level. Results:The prevalence of psychotropic drug use in the sample was 13.4%; specifically, 8.3% of individuals surveyed used benzodiazepines, whereas 5.0% used antidepressants. The following factors were independently associated with the use of psychotropic drugs: female gender (OR = 2.20; 95%CI 1.49 -3.27), medical diagnosis of depression (OR = 6.42; 95%CI 4.31 -9.55), 5 or more medical appointments in the last 12 months (OR = 2.15; 95%CI 1.32 -3.53), and subscription to private health insurance (OR = 2.69; 95%CI 1.86 -3.88). Conclusion:The prevalence observed was similar to the one verified in other elderly Brazilian populations and the pattern of associated factors was consistent with the one detected for older populations of higher-income countries. Medical diagnosis of depression was the factor most strongly associated with psychotropic drug use.

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“…[12][13][14][15][16][17][18] However, the dearth of published research studies on this subject suggests that such recommendations have not had a significant impact on the use of benzodiazepines and Z-drugs in various countries. [19][20][21][22] The only population-based study conducted in Canada was based on data from British Columbia and examined a period of 10 years between 1996 and 2006. 20 As there are long delays between the reporting of scientific knowledge and changes in clinical practice, changes in prescribing patterns may have occurred over the last 7 years.…”

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confidence: 99%

Use of benzodiazepines and related drugs in Manitoba: a population-based study

et al. 2014

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Background: Despite their favourable toxicology profile, benzodiazepines and the related Z-drugs (zopiclone, zolpidem and zaleplon) have been associated with physiological tolerance, dependence and addiction. Evidence of harm (e.g., falls, motor vehicle collisions and cognitive disturbances) has been reported in older populations. The aim of this study was to determine the relation between users' characteristics and the use of benzodiazepines and Z-drugs in Manitoba over a 16-year period. Methods:This time-series analysis was based on prescription data from Apr. 1, 1996, to Mar. 31, 2012, obtained from the Drug Product Information Network database of Manitoba. We obtained sociodemographic information on benzodiazepine and Z-drug users from the Population Registry and determined changes in utilization rates over time using generalized estimating equations.Results: Overall, the prevalence of benzodiazepine use remained stable at about 61.0 per 1000 population between 1996/97 and 2011/12; however, the prevalence of Z-drug use increased steadily from 10.9 to 37.0 per 1000 over the same period. In older people (≥ 65 yr), the incidence of benzodiazepine use decreased from 55.5 to 30.3 users per 1000, whereas the incidence of Z-drug use increased from 7.3 to 20.3 users per 1000 over the study period. Among those 18-64 years of age, the incidence of benzodiazepine use decreased from 30.1 to 27.6 users per 1000, but the increase in incidence of Z-drug use was more than 2-fold. The youngest population (≤ 17 yr) showed the lowest rates of use of these drugs. The highest rates of use were observed among older women and the low-income population.Interpretation: Over the study period, benzodiazepines have been prescribed less frequently to older patients in Manitoba; however, zopiclone prescribing has continued to increase for all age groups. The reasons for this increase remain to be determined. AbstractCMAJ OPEN, 2(4) E209 Research CMAJ OPEN Methods Study populationAll Manitoba residents registered with the provincial health care system who were prescribed a benzodiazepine or a Z-drug between 1996/97 and 2011/12 were included. No age restrictions were applied, but patients were stratified by sex and age (0-17, 18-64 and ≥ 65 yr). Location of residence (urban v. rural) and socioeconomic status were also assessed. According to validated definitions, 23 incident (new) users were defined as people who had not received a prescription for any of the medications of interest in the year before receiving their first prescription, while prevalent users for each fiscal year were defined as people who had received at least 1 pres cription for a medication of interest that year.

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Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011

Cited by 202 publications

References 49 publications

Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women

Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women

Uso de psicofármacos entre idosos residentes em comunidade: prevalência e fatores associados

Use of benzodiazepines and related drugs in Manitoba: a population-based study

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