title: Pharmacoepidemiological characterization of psychotropic drugs consumption using a latent class analysis.
abstract: France has one of the highest recorded rates of psychotropic use of drugs compared with other European countries, especially for anxiolytics, hypnotics and antidepressants. The aim of this study was to characterize the use of three psychotropic drugs among the most prescribed in France (bromazepam, paroxetine, zolpidem) using reimbursement databases in real-life conditions. Individuals from a region affiliated to the French General Health Insurance Scheme, who had received at least two dispensings of bromazepam, paroxetine or zolpidem reimbursed between 1 January and 30 June 2008, were included. We used a latent class analysis to identify different subgroups of users for these three psychotropic drugs. A total of 40,644 patients were included for bromazepam, 36,264 for zolpidem and 31,235 for paroxetine. Using latent class analysis, four clinical subtypes of users of bromazepam and zolpidem were identified: nonproblematic users, at-risk users, users with a probable mental disorder and compulsive users. Three subgroups were identified for paroxetine that differed rather by the prescription patterns. Users of anxiolytics and hypnotics with at-risk behaviours represented a significant proportion in the studied population. This original method could be extended to other prescription databases to identify populations at risk of abuse or dependence to psychotropic drugs.
authors.affiliation: Department of Clinical Pharmacology, Center for Evaluation and Information on Pharmacodependence, Nantes University Hospital, Nantes, France. laura.wainstein@chu-nantes.fr
authors.forename: Laura
authors.initials: L
authors.lastname: Wainstein
authors.forename: Caroline
authors.initials: C
authors.lastname: Victorri-Vigneau
authors.forename: Véronique
authors.initials: V
authors.lastname: Sébille
authors.forename: Jean-Benoît
authors.initials: JB
authors.lastname: Hardouin
authors.forename: Fanny
authors.initials: F
authors.lastname: Feuillet
authors.forename: Jacques
authors.initials: J
authors.lastname: Pivette
authors.forename: Anicet
authors.initials: A
authors.lastname: Chaslerie
authors.forename: Pascale
authors.initials: P
authors.lastname: Jolliet
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001960:Bromazepam / Q000627:therapeutic use*; D016208:Databases, Factual; D004363:Drug Utilization; D005602:France / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D017374:Paroxetine / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D012306:Risk; D019966:Substance-Related Disorders / Q000209:etiology; D000077334:Zolpidem
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives; D011725:Pyridines; D017374:Paroxetine; D000077334:Zolpidem; D001960:Bromazepam