Work

Simultaneous Benzodiazepine and SSRI Initiation in Young People With Anxiety Disorders

Year: 2021

Type: article

Abstract: There are potential risks and benefits of combining benzodiazepine (BZD) and selective serotonin reuptake inhibitor (SSRI) therapy at anxiety disorder treatment onset. We investigated how often adolescents and young adults with anxiety disorders simultaneously initiate BZD treatment with SSRI treatment and examined whether SSRI treatment duration varies by simultaneous BZD initiation. anxiety disorder diagnoses initiating SSRI treatment, without past-year SSRI and BZD treatment. We defined simultaneous initiation as filling a new BZD prescription on the date of SSRI initiation. We estimated time to SSRI treatment discontinuation and used stabilized inverse probability of treatment weighting for adjusted estimates. The study included 94,399 adolescents and 130,971 young adults initiating SSRI treatment with an anxiety disorder. Four percent of adolescents and 17% of young adults simultaneously initiated BZD treatment, varying by age, anxiety disorder, comorbidities, health care utilization, and provider type. Simultaneous BZD initiation among SSRI initiators declined from 2008 to 2016. SSRI treatment duration was similar in initiators of simultaneous therapy vs SSRI monotherapy: ≥ 6 months in adolescents (55% vs 56%, respectively) and in young adults (39% vs 40%). Nine percent of simultaneous initiators continued BZDs for ≥ 6 months. Simultaneous initiation of BZD and SSRI treatment is relatively common in young adults with anxiety disorders and was not associated with longer SSRI persistence. Given risks of BZD treatment, potential benefits and risks of adding a BZD at SSRI treatment initiation must be carefully weighed.

Source: The Journal of Clinical Psychiatry

DOI: 10.4088/jcp.20m13863

Authors: Greta A. Bushnell, Moira A. Rynn, Stephen Crystal, Tobias Gerhard, Mark Olfson

Institutions: Rutgers, The State University of New Jersey, Duke University, Duke Medical Center, Columbia University Irving Medical Center, Columbia University

Language: English

Topic: Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Subfield: Experimental and Cognitive Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: green

Funders: Agency for Healthcare Research and Quality, National Institute of Mental Health, National Institute on Drug Abuse, National Center for Advancing Translational Sciences