- Researchers explored trends in anxiety treatment prescribing in primary care in the UK between 2003 and 2018.
- Prescriptions for anxiety increased sharply between 2008 and 2018, especially among young adults.
- The authors say that some prescriptions contradict the guidelines and can cause unintended harm.
Feelings of worry or nervousness are part of many people’s lives. However, when feelings of worry become persistent, distressing, and interfere with daily life, anxiety may require treatment.
This is not uncommon; anxiety disorders are the most common group of mental health problems in the United States, affecting approximately 40 million people.
Medicines for anxiety – known as anxiolytics – include benzodiazepines, beta-blockers, antipsychotics and anticonvulsants. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs), may also be prescribed for anxiety.
Recent research has shown an increase in prescriptions for depression, with a study in England finding a tripling of prescriptions for antidepressants in 20 years. However, prescribing patterns for anxiety are less well understood.
To investigate this, a team of researchers from the University of Bristol, UK, assessed prescribing for anxiety in primary care in the UK. Their results, now published in the British Journal of General Medicineshow a sharp increase in prescriptions for anxiety between 2008 and 2018, especially among young adults.
The researchers used data from an anonymised database of electronic health records in the UK. This included data from more than 2.5 million people registered in 176 primary care practices across the UK.
The results showed a significant increase in prescribing for anxiety. The prevalence of prescriptions for all drugs, excluding benzodiazepines, increased over the study period, with a marked increase from 2008 to 2018. Over the entire study period (2003-2018 ), the prevalence of anxiolytic prescriptions increased by almost a factor of two.
This trend is explained by the increase in the number of new patients starting treatment for anxiety, particularly among young adults (18 to 35 years old).
This reflects an increase in the number of people suffering from anxiety, said Professor Thalia Eley, professor of developmental behavioral genetics at King’s College London. Medical News Today.
“Previous papers have shown that anxiety disorders are being diagnosed at increasing rates, particularly among young adults, particularly women. This paper suggests that the increased treatment needs of these young adults are at least partially met by the use of drugs.
Professor Eley studies the development and treatment of anxiety and depression, but was not involved in the study.
There were some differences in prescribing trends by drug class. New beta-blocker prescriptions increased over the study period. However, benzodiazepine prescriptions have declined.
Among young adults, however, the researchers found an increase in new drug prescriptions in every class. This includes prescriptions for antidepressants (especially for those under 25) and benzodiazepines.
The authors state that there are several possible reasons for the increase in prescribing for this age group, including increased levels of anxiety, better detection of anxiety, and greater medication acceptance.
“The increase may also reflect a prior unmet need for these patients, given pressures on Child and Adolescent Mental Health Services (CAMHS),” said the study’s lead author, Dr Charlotte. Archer. MNT.
Dr Archer, Senior Mental Health Research Associate in Primary Care, Bristol Medical School, University of Bristol, UK, explained that more than a quarter of referrals to CAMHS were rejected in 2018-2019, which could result in an influx of people seeking help from primary institutions. care.
Researchers warn that some prescriptions are not based on solid evidence and may contradict guidelines. They note, for example, a clear increase in benzodiazepine prescriptions among young adults, despite the risk of dependence.
Nearly half of benzodiazepine prescriptions issued in 2017 lasted longer than the recommended 4 weeks.
The authors also urge caution with long-term use of antidepressants. “Once patients start taking antidepressants, they often continue to take them long term. However, antidepressants and other anxiolytics can have unwanted side effects, and there is growing evidence that patients may have difficulty stopping treatment,” Dr. Archer explained.
Some patients experience withdrawal symptoms after stopping treatment, which can exacerbate symptoms of anxiety.
To address these risks, scientists call for more research to understand the reasons for the rise in prescribing anxiety, especially among young adults. They also say that non-pharmacological methods of intervention are needed.
“There is a need to expand the choice of treatment options for patients with anxiety. We know that psychological therapies can be effective for anxiety, but we need to increase access to these interventions and ensure they are delivered in an acceptable way, especially for young adults.
– Dr. Archer
Professor Eley explained that there is significant literature showing the benefits of cognitive behavioral therapy for anxiety across all age groups, but access to such treatment can be a challenge in the UK. due to long waiting lists.
“Psychological therapies have become more accessible to patients in the UK since the advent of NHS Improving Access to Psychological Treatment (IAPT) services, but there are long waiting lists and it is plausible that some young adults are taking drugs despite their preference for psychological treatment, as it is available more quickly.
The authors of the study mention a key limitation to their study. Although the researchers only included prescriptions where patients had had a symptom or diagnosis of anxiety within 3 months before or 6 months after a prescription, they could not know for certain that the drugs were prescribed for anxiety.
Some of the drugs the researchers looked at may have been prescribed for other conditions, such as depression. Antidepressants are commonly prescribed to treat anxiety, so some of the people included in the study may have treated their depression rather than their anxiety with the drugs. Therefore, the study figures may be overestimated.