Study,Oct/21: Benzo, Z-Drug & Serotonergics Use in U.S. Before & During COVID

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The full title of this American study is "Trends in the Use of Benzodiazepines, Z-Hypnotics, and Serotonergic Drugs Among US Women and Men Before and During the COVID-19 Pandemic".

 

https://pubmed.ncbi.nlm.nih.gov/34694388/

 

 

Abstract

 

Importance: The ongoing COVID-19 pandemic and associated mitigation measures have disrupted access to psychiatric medications, particularly for women.

 

Objective: To assess the sex differences in trends in the prescribing of benzodiazepines, Z-hypnotics and serotonergic (selective serotonin reuptake inhibitors [sSRIs] and serotonin and norepinephrine reuptake inhibitors [sNRIs]), which are commonly prescribed for anxiety, insomnia, and depression.

 

Design, setting, and participants: This cohort study used data from Clinformatics Data Mart, one of the largest commercial health insurance databases in the US. Enrollees 18 years or older were required to have complete enrollment in a given month during our study period, January 1, 2018, to March 31, 2021, to be included for that month.

 

Main outcomes and measures: Prescription of a benzodiazepine, Z-hypnotic, or SSRI or SNRI. For each month, the percentage of patients with benzodiazepine, Z-hypnotic, or SSRI or SNRI prescriptions by sex was calculated.

 

Results: The records of 17 255 033 adults (mean [sD] age, 51.7 [19.5] years; 51.3% female) were examined in 2018, 17 340 731 adults (mean [sD] age, 52.5 [19.7] years; 51.6% female) in 2019, 16 916 910 adults (mean [sD] age, 53.7 [19.8] years; 51.9% female) in 2020, and 15 135 998 adults (mean [sD] age, 56.2 [19.8] years; 52.5% female) in 2021. Compared with men, women had a higher rate of prescriptions for all 3 drugs classes and had larger changes in prescription rates over time. Benzodiazepine prescribing decreased from January 2018 (women: 5.61%; 95% CI, 5.60%-5.63%; men: 3.03%; 95% CI, 3.02%-3.04%) to March 2021 (women: 4.91%; 95% CI, 4.90%-4.93%; men: 2.66%; 95% CI, 2.65%-2.67%), except for a slight increase in April 2020 among women. Z-hypnotic prescribing increased from January 2020 for women (1.39%; 95% CI, 1.38%-1.40%) and February 2020 for men (0.97%; 95% CI, 0.96%-0.98%) to October 2020 (women: 1.46%; 95% CI, 1.46%-1.47%; men: 1.00%; 95% CI, 0.99%-1.01%). Prescribing of SSRIs and SNRIs increased from January 2018 (women: 12.77%; 95% CI; 12.75%-12.80%; men: 5.56%; 95% CI, 5.44%-5.58%) to April 2020 for men (6.73%; 95% CI, 6.71%-6.75%) and October 2020 for women (15.18%; 95% CI, 15.16%-15.21%).

 

Conclusions and relevance: In this cohort study, coinciding with the COVID-19 pandemic onset was an increase in Z-hypnotic as well as SSRI and SNRI prescriptions in both men and women along with an increase in benzodiazepine prescriptions in women, findings that suggest a substantial mental health impact of COVID-19-associated mitigation measures.

Conflict of interest statement

 

Conflict of Interest Disclosures: Dr Milani reported receiving grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, nonfinancial support from the University of Texas Medical Branch Claude D. Pepper Older Americans Independence Center, and grants from the Texas Resource Center for Minority Aging Research during the conduct of the study. Drs Raji and Kuo reported receiving grants from the National Institute on Drug Abuse, National Institutes of Health, and serving as multiple principal investigators on research with the National Institute on Drug Abuse, National Institutes of Health, during the conduct of the study. No other disclosures were reported.

 

Full Study:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546497/