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Simultaneous antidepressant, benzodiazepine use comparable to antidepressant treatment

Simultaneous antidepressant and benzodiazepine new use did not significantly differ from antidepressant treatment at 6 months, according to recent findings.

“Despite cautions and concerns, benzodiazepines are commonly prescribed during antidepressant treatment; 10% to 57% of antidepressant users receive benzodiazepines or other anxiolytics at some time during antidepressant treatment. Less is known about the specific practice of simultaneously beginning benzodiazepine therapy with antidepressant therapy,” Greta A. Bushnell, MSPH, of University of North Carolina at Chapel Hill, and colleagues wrote.

To determine trends in simultaneous benzodiazepine and antidepressant new use among adults with depression initiating antidepressant treatment, researchers analyzed U.S. commercial claims from 2001 through 2014 for adults with a recent depression diagnosis who initiated antidepressant treatment but had not used antidepressants or benzodiazepines in the past year. The cohort included 765,130 adults with a median age of 39 years.

From 2001 to 2014, the mean annual increase in the proportion of simultaneous use was 0.49%, increasing from 6.1% in 2001 to 12.5% in 2012 and stabilizing through 2014 at 11.3%.

Researchers found similar associations by age group and physician type.

Antidepressant treatment length did not significantly differ between simultaneous new users and nonsimultaneous new users.

Long-term benzodiazepine use occurred among 12.3% of simultaneous new users and 64% discontinued benzodiazepine use after initial prescription fill.

Determinants of long-term benzodiazepine use after simultaneous use included longer initial benzodiazepine days’ supply, first prescription for a long-acting benzodiazepine and recent prescription opioid fills.

“Because of the risks associated with benzodiazepines and the potentially modifiable factors associated with long-term use among simultaneous new users, the decision to simultaneously initiate benzodiazepine therapy at antidepressant therapy initiation and the benzodiazepine regimen require careful consideration of potential benefits and harms,” the researchers wrote. – by Amanda Oldt

Disclosure: Bushnell reports previously holding a graduate research assistantship with GlaxoSmithKline and receiving funding through the Center for Pharmacoepidemiology, Department of Epidemiology University of North Carolina Gillings School of Global Public Health (both ended in December 2015). Please see the study for a full list of relevant financial disclosures.