title: Prescribing of selective serotonin reuptake inhibitors, anxiolytics, and sedative-hypnotics by general practitioners in The Netherlands: a multivariate analysis.
abstract: A study of the prescribing of anxiolytics and sedative-hypnotics and the occurrence of anxiety or sleep disorders before and after the initiation of selective serotonin reuptake inhibitor (SSRI) therapy may provide insight into differences in individual SSRIs. The purpose of our study was to evaluate whether and in what way the likelihood of being prescribed an anxiolytic or sedative-hypnotic or receiving a diagnosis of an anxiety or sleep disorder differed in patients prescribed either fluoxetine or paroxetine by a general practitioner (GP) in the Netherlands, where these two agents are the most commonly prescribed SSRIs. Episodes of SSRI treatment were constructed from a recently available GP database in the Netherlands. Logistic regression analysis was used to determine whether, after controlling for other observable factors, the receipt of paroxetine or fluoxetine was a statistically significant determinant for receipt of an anxiolytic or sedative-hypnotic or a diagnosis of an anxiety or sleep disorder. We found that patients who were prescribed fluoxetine as their index drug were less likely to receive a concomitant sedative-hypnotic on their index date compared with patients receiving paroxetine. After controlling for other observable factors, such as use of anxiolytics and sedative-hypnotics before SSRI therapy or on the index date or the existence of comorbid anxiety or sleep disorders, patients starting fluoxetine therapy were no more likely than patients starting paroxetine therapy to receive an anxiolytic or sedative-hypnotic or a diagnosis of an anxiety or sleep disorder during the 60-day post period. The likelihood of a patient's being diagnosed with or receiving a prescription for an anxiety or sleep disorder does not appear to be a differentiating factor between the prescribing of fluoxetine or paroxetine by GPs in the Netherlands.
authors.affiliation: Degge Group, Ltd., Arlington, Virginia, USA.
authors.forename: A
authors.initials: A
authors.lastname: Pathiyal
authors.forename: T R
authors.initials: TR
authors.lastname: Hylan
authors.forename: J K
authors.initials: JK
authors.lastname: Jones
authors.forename: D
authors.initials: D
authors.lastname: Davtian
authors.forename: L
authors.initials: L
authors.lastname: Sverdlov
authors.forename: M
authors.initials: M
authors.lastname: Keyser
mesh_terms: D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy*; D003863:Depression / Q000188:drug therapy*; D005194:Family Practice; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D016015:Logistic Models; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D017374:Paroxetine / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000188:drug therapy; D019966:Substance-Related Disorders
chemical_list: D014151:Anti-Anxiety Agents; D005473:Fluoxetine; D006993:Hypnotics and Sedatives; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors