OBJECTIVE: To analyze the effects of concomitant anxiolytic/hypnotic use on duration of antidepressant therapy. The study was part of a national quality improvement initiative to understand current practices and improve the quality of care provided to patients by primary care physicians and psychiatrists. DESIGN: A naturalistic, retrospective analysis using prescription, diagnosis, and eligibility databases. SETTING: A national managed care organization (MCO) and its behavioral health subsidiary. PATIENTS: 23,900 new patients who received benefits through a national MCO and initiated antidepressant therapy in mid-1995. The study population included adults who were continuously eligible for medical and pharmacy benefits during the study period and received at least one prescription for one of eight antidepressants between April 1, 1995 and August 31, 1995. MAIN OUTCOME MEASURES: Concomitant anxiolytic and hypnotic use patterns were evaluated in the nine months following therapy initiation. RESULTS: Patients with extended use of anxiolytics or hypnotics also had the longest duration of antidepressant therapy; patients with brief use of anxiolytics or hypnotics had the shortest duration of antidepressant therapy, regardless of prescriber type. Psychiatrists were more likely than primary care providers to prescribe concomitant anxiolytics/hypnotics and were more likely to prescribe antidepressants for longer duration of therapy across all categories of anxiolytic/hypnotic use. CONCLUSIONS: As a result of these findings, interventions were targeted at educating primary care providers and psychiatrists about limiting the duration of concomitant anxiolytic/hypnotic use and improving the understanding of depression and its relation to individual anxiety symptoms.
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Karen Way (2000) studied this question.