title: The utilization of antidepressants and benzodiazepines among people with major depression in Canada.
abstract: OBJECTIVE
  Although clinical guidelines recommend monotherapy with antidepressants (ADs) for major depression, polypharmacy with benzodiazepines (BDZs) remains an issue. Risks associated with such treatments include tolerance and dependence, among others. We assessed the prevalence and determinants of AD and BDZ utilization among Canadians who experienced a major depressive episode (MDE) in the previous 12 months, and determined the association of seeing a psychiatrist on the utilization of ADs and BDZs.
  
  
  METHODS
  Data were drawn from the 2002 Canadian Community Health Survey: Health and Well-Being, a nationally representative sample of Canadians aged 15 years and older. Descriptive statistics quantified utilization, while logistic regression identified factors associated with utilization, such as sociodemographic characteristics or type of physician seen. Sampling weights and bootstrap variance estimations were used for all analysis.
  
  
  RESULTS
  The overall prevalence of AD and BDZ utilization was 49.3% of respondents who experienced an MDE in the past 12 months and reported AD use. Key determinants of utilization were younger age and unemployment in the past week (OR 2.6; P < 0.001). Being seen by a psychiatrist increased utilization (OR 2.5; P < 0.001), possibly because psychiatrists were seeing patients with severe depression.
  
  
  CONCLUSIONS
  A large proportion of people with past-year MDEs utilized ADs and BDZs. It is unclear how much of this is appropriate given that evidence-based clinical guidelines recommend monotherapy with ADs in the treatment of major depression.
authors: Graduate Student, Dalhousie University, Halifax, Nova Scotia. c.sanyal@dal.ca
authors: Chiranjeev
authors: C
authors: Sanyal
authors: Mark
authors: M
authors: Asbridge
authors: Steve
authors: S
authors: Kisely
authors: Ingrid
authors: I
authors: Sketris
authors: Pantelis
authors: P
authors: Andreou
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D002170:Canada; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D057566:Self Report; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D001569:Benzodiazepines