MedicalResearch.com Interview with:
Greta A Bushnell, MSPH
Doctoral Candidate, Department of Epidemiology
UNC, Gillings School of Global Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Patients with depression may be co-prescribed a benzodiazepine at antidepressant initiation for a short period for a variety of reasons. Reasons include reducing concurrent anxiety and insomnia, reducing depression severity more quickly, and improved antidepressant continuation. However, there are concerns with benzodiazepines including dependency. As such, benzodiazepines are usually recommended for only short-term treatment.
Prior to our study, little was known about a) how often new simultaneous antidepressant and benzodiazepine prescribing occurred among patients initiating antidepressant treatment for depression or b) whether new simultaneous users became long-term benzodiazepine users.
In a large commercial insurance database, we identified adults aged 18-64 years with depression who initiated an antidepressant from 2001 to 2014. We found that 11% of adults simultaneously initiated benzodiazepine treatment, which increased from 6% in 2001 to a peak at 12% in 2012. We observed similar antidepressant treatment length at six months in simultaneous new users and among patients initiating antidepressants only. The majority of simultaneous new users had only one benzodiazepine prescription fill before benzodiazepine discontinuation; however, 12% were identified as long-term benzodiazepine users.
MedicalResearch.com: What should readers take away from your report?
Response: New simultaneous antidepressant and benzodiazepine use appears to be relatively common in the privately insured US adult population under 65. Since a subset of patients demonstrated subsequent long-term benzodiazepine use, there is a need for ongoing consideration of the potential benefit and harm of new simultaneous benzodiazepine use in this setting.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Given that benzodiazepines have been previously associated with an increased risk for accidents such as motor vehicle crashes, one area for future research would be investigating whether simultaneous new use of benzodiazepines puts antidepressant initiators at an increased risk for harmful outcomes compared with patients who initiate antidepressants without benzodiazepines. This research question would further add to our understanding of the potential benefit and harm of simultaneous new use.
MedicalResearch.com: Is there anything else you would like to add?
Response: This research was completed during my predoctoral training in epidemiology at the University of North Carolina at Chapel Hill in collaboration with clinicians and researchers from UNC and Northeastern University. I receive support from the National Institute of Mental Health as a Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellow.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Bushnell GA, Stürmer T, Gaynes BN, Pate V, Miller M. Simultaneous Antidepressant and Benzodiazepine New Use and Subsequent Long-term Benzodiazepine Use in Adults With Depression, United States, 2001-2014. JAMA Psychiatry. Published online June 07, 2017. doi:10.1001/jamapsychiatry.2017.1273
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