CONCOMITANT PRESCRIBING OF TRANQUILIZERS AND HYPNOTICS AMONG PATIENTSRECEIVING ANTIDEPRESSANT PRESCRIPTIONS

OBJECTIVE: To evaluate concomitant prescribing of tranquilizers and hy pnotics in antidepressant treatment with particular focus on the relat ionship to drug class in patients prescribed antidepressant treatment for depressive disorders. DESIGN AND METHODS: Repeated cross-sectional surveys of Swedish physicians in ambulatory care from 1991 to 1996, i ncluding specialty practices. The participation rate was 65-70%. RESUL TS: Tranquilizers and hypnotics were prescribed in 36.1% of the visits in which the intention was to treat depression. Concomitant prescribi ng increased with the patient's age for all antidepressant drug classe s. Women received more concomitant prescriptions than men when treated with nonselective monoamine-reuptake inhibitors (NSMRI), mainly tricy clic compounds. Psychiatrists prescribed more concomitant tranquilizer s and hypnotics than other physicians, and general practitioners fewer , when treating depression with selective serotonin-reuptake inhibitor s (SSRIs), mainly citalopram. A logistic regression model showed that the risk for concomitant prescribing was higher when an NSMRI was pres cribed than with other antidepressants. CONCLUSIONS: Concomitant presc ribing of tranquilizers and hypnotics was common among antidepressant- treated patients. The most plausible reasons for the high rate of conc omitant prescribing were the symptoms of the depression itself and/or the common comorbidity with anxiety disorders seen in this group of pa tients. The results of this study indicate that the concern about incr eased tranquilizer and hypnotic use among patients treated with SSRIs suggested in other studies seems to be unfounded in Sweden.