Skip to main content
SpringerLink
Log in

How Do Different Age Groups Use Benzodiazepines and Antidepressants?

Analysis of an Australian Administrative Database, 2003–6

  • Original Research Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Background: The use of antidepressants and benzodiazepines is increasing in Australia and worldwide, and it is thought that some of the prescribing of these classes of drugs may be inappropriate. However, the demographic characteristics of the subgroups of the population responsible for this increase remain unexplored.

Objective: The aim of this study was to examine changes in the utilization of antidepressants and benzodiazepines between different age groups within Australia from 2003 to 2006.

Methods: The Australian Pharmaceutical Benefits Scheme administrative database was used to obtain dispensing data for all antidepressants and publicly subsidized benzodiazepines. Changes in utilization (amounts and patterns of use of different compounds) were compared between different age groups from 2003 to 2006. The WHO Anatomic Therapeutic Chemical/Defined Daily Dose system was used.

Results: Use of antidepressants increased from 2003 to 2006, and in each year increased with age, with those ≥65 years having the greatest use. Differences were seen in the antidepressant most utilized, with the elderly using more tricyclic antidepressants than those who are younger. The utilization of benzodiazepines decreased from 2003 to 2006 in elderly individuals and those receiving social welfare benefits. Individuals aged ≥85 years had the highest use of benzodiazepines and used more long-acting benzodiazepines compared with those aged 35–44 years.

Conclusion: The elderly still account for most use per capita of benzodiazepines. Some of this use may be inappropriate (e.g. use of long-acting benzodiazepines) and, hence, may represent a useful target for future educational intervention. The elderly also still account for the largest per capita use of antidepressants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Argyropoulos SV, Nutt DJ. The use of benzodiazepines in anxiety and other disorders. Eur Neuropsychopharmacol 1999 Dec; 9Suppl. 6: S407–12

    Article  PubMed  CAS  Google Scholar 

  2. Therapeutic Guidelines Limited. eTG complete [online]. Available from URL: http://etg.hcn.net.au [Accessed 2008 Dec]

  3. Smith A, Sketris I, Cooke C, et al. A comparison of benzodiazepines and related drug use in Nova Scotia, Canada and Australia. Can J Psychiatry 2008; 53(8): 546–52

    Google Scholar 

  4. Mant A, Rendle VA, Hall WD, et al. Making new choices about antidepressants in Australia: the long view 1975–2002. Med J Aust 2004 Oct 4; 181 (7 Suppl.): S21–4

    PubMed  Google Scholar 

  5. Buffett-Jerrott SE, Stewart SH. Cognitive and sedative effects of benzodiazepine use. Curr Pharm Des 2002; 8(1): 45–58

    Article  PubMed  CAS  Google Scholar 

  6. French DD, Campbell R, Spehar A, et al. Benzodiazepines and injury: a risk adjusted model. Pharmacoepidemiol Drug Saf 2005 Jan; 14(1): 17–24

    Article  PubMed  Google Scholar 

  7. Aparasu R, Mort J. Inappropriate prescribing for the elderly: Beers criteria-based review. Ann Pharmacother 2000; 34(3): 338–46

    Article  PubMed  CAS  Google Scholar 

  8. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly: an update. Arch Intern Med 1997 Jul 28; 157(14): 1531–6

    Article  PubMed  CAS  Google Scholar 

  9. Fick DM, Cooper JW, Wade WE, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 2003 Dec 8–22; 163(22): 2716–24

    Article  PubMed  Google Scholar 

  10. Alonso J, Angermeyer MC, Bernert S, et al. Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 2004; 109(420): 55–64

    Article  Google Scholar 

  11. MaGPIe Research Group. The treatment of common mental health problems in general practice. Fam Pract 2006; 23: 53–9

    Article  Google Scholar 

  12. Simon GE, Fleck M, Lucas R, et al. Prevalence and predictors of depression treatment in an international primary care study. Am J Psychiatry 2004 Sep; 161(9): 1626–34

    Article  PubMed  Google Scholar 

  13. Lambert MF, Masters GA, Brent SL. Can mass media campaigns change antimicrobial prescribing? A regional evaluation study. J Antimicrob Chemother 2007 Mar; 59(3): 537–43

    Article  PubMed  CAS  Google Scholar 

  14. Randolph W, Viswanath K. Lessons Learned from public health mass media campaigns: marketing health in a crowded media world. Annu Rev Public Health 2004; 25: 419–37

    Article  PubMed  Google Scholar 

  15. Australian Government Department of Health and Aging. Pharmaceutical benefit scheme (PBS) [online]. Available from URL: http://www.pbs.gov.au/html/consumer/pbs/about [Accessed 2008 Nov 26]

  16. Australian Government. Medicare Australia [online]. Available from URL: http://www.medicareaustralia.gov.au/ [Accessed 2008 Nov 26]

  17. Australia Bureau of Statistics. Population by age and sex, Australian States and Territories [online]. Available from URL: http://www.abs.gov.aU/AUSSTATS/abs@.nsf/MF/3201.0 [Accessed 2008 Dec]

  18. Australian Government. Centrelink [online]. Available from URL: http://www.centrelink.gov.au/ [Accessed 2008 Nov 26]

  19. Sketris I, Metge C, Ross J, et al. The use of the World Health Organisation Anatomical Therapeutic Chemical/Defined Daily Dose methodology in Canada. Drug Inf J 2004; 38(1): 15–27

    Article  Google Scholar 

  20. World Health Organisation. WHO Collaborating Centre for Drug Statistics Methodology, guidelines for ATC classification and DDD assignment 2006. 9th ed. Oslo: WHO Collaborating Centre for Drug Statistics Methodology, 2005

    Google Scholar 

  21. Bergman U, Popa C, Tomson Y, et al. Drug utilization 90%: a simple method for assessing the quality of drug prescribing. Eur J Clin Pharmacol 1998 Apr; 54(2): 113–8

    Article  PubMed  CAS  Google Scholar 

  22. Bambauer KZ, Adams AS, Zhang F, et al. Physician alerts to increase antidepressant adherence: fax or fiction? Arch Intern Med 2006 Mar 13; 166(5): 498–504

    Article  PubMed  CAS  Google Scholar 

  23. Dollman WB, Leblanc VT, Stevens L, et al. Achieving a sustained reduction in benzodiazepine use through implementation of an area-wide multi-strategic approach. J Clin Pharm Ther 2005 Oct; 30(5): 425–32

    Article  PubMed  CAS  Google Scholar 

  24. Mant A, Walsh RA. Reducing benzodiazepine use. Drug Alcohol Rev 1997 Mar; 16(1): 77–84

    Article  PubMed  CAS  Google Scholar 

  25. National Prescribing Service. Benzodiazepines [online]. Available from URL: http://www.nps.org.au/health_professionals/drug_and_therapeutics_topics/ [Accessed 2008 Dec]

  26. Richards JC, Ryan P, McCabe MP, et al. Barriers to the effective management of depression in general practice. Aust N Z J Psychiatry 2004 Oct; 38(10): 795–803

    Article  PubMed  Google Scholar 

  27. Howard M, Dolovich L, Kaczorowski J, et al. Prescribing of potentially inappropriate medications to elderly people. Fam Pract 2004 Jun; 21(3): 244–7

    Article  PubMed  Google Scholar 

  28. McGarry H, Hegarty K, Gunn J. How do Victorian GPs manage patients with depression? Aust Fam Physician 2005 Jul; 34(7): 603–6

    PubMed  Google Scholar 

  29. Goldney RD, Fisher LJ, Grande ED, et al. Have education and publicity about depression made a difference? Comparison of prevalence, service use and excess costs in South Australia: 1998 and 2004. Aust N Z J Psychiatry 2007 Jan; 41(1): 38–53

    Article  PubMed  Google Scholar 

  30. Sihvo S, Isometsa E, Kiviruusu O, et al. Antidepressant utilisation patterns and determinants of short-term and non-psychiatric use in the Finnish general adult population. J Affect Disord 2008 Sep; 110(1–2): 94–105

    Article  PubMed  Google Scholar 

  31. Hollingworth S, Nissen L. Use of tricyclic antidepressants in Australia. University of Queensland, 2008. (Data on file)

    Google Scholar 

  32. Anstey KJ, von Sanden C, Sargent-Cox K, et al. Prevalence and risk factors for depression in a longitudinal, population-based study including individuals in the community and residential care. Am J Geriatr Psychiatry 2007 Jun 1; 15(6): 497–505

    Article  PubMed  Google Scholar 

  33. Smith AJ, Sketris I, Cooke C, et al. A comparison of antidepressant use in Nova Scotia, Canada and Australia. Pharmacoepidemiol Drug Saf 2008 Jul; 17(7): 697–706

    Article  PubMed  Google Scholar 

  34. Mant A, Whicker SD, McManus P, et al. Benzodiazepine utilisation in Australia: report from a new pharmacoepidemiological database. Aust J Public Health 1993 Dec; 17(4): 345–9

    Article  PubMed  CAS  Google Scholar 

  35. Mant A, McManus P. Benzodiazepine use: continuing to fall [letter]. Med J Aust 1994 Oct 3; 161(7): 454

    PubMed  CAS  Google Scholar 

  36. Voyer P, Verreault R, Mengue PN, et al. Prevalence of insomnia and its associated factors in elderly long-term care residents. Arch Gerontol Geriatr 2006; 42(1): 1–20

    Article  PubMed  Google Scholar 

  37. Ohayon MM, Caulet M, Priest RG, et al. Psychotropic medication consumption patterns in the UK general population. J Clin Epidemiol 1998; 51(3): 273–83

    Article  PubMed  CAS  Google Scholar 

  38. Rojas-Fernandez CH, Carver D, Tonks R. Population trends in the prevalence of benzodiazepine use in the older population of Nova Scotia: a cause for concern? Can J Clin Pharmacol 1999 Autumn; 6(3): 149–56

    PubMed  CAS  Google Scholar 

  39. Pariente A, Dartigues JF, Benichou J, et al. Benzodiazepines and injurious falls in community dwelling elders. Drugs Aging 2008; 25(1): 61–70

    Article  PubMed  CAS  Google Scholar 

  40. Australian Government. Australian medicines handbook [online]. Available from URL: http://amh.hcn.net.au/ [Accessed 2008 Nov 26]

Download references

Acknowledgements

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

Author information

Authors and Affiliations

  1. School of Health Sciences, Highfield, Building 67, Southampton, SO17 1BJ, UK

    Alesha J. Smith

  2. School of Pharmacy, University of Queensland, Brisbane, Queensland, Australia

    Alesha J. Smith & Sue E. Tett

Authors
  1. Alesha J. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sue E. Tett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alesha J. Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, A.J., Tett, S.E. How Do Different Age Groups Use Benzodiazepines and Antidepressants?. Drugs Aging 26, 113–122 (2009). https://doi.org/10.2165/0002512-200926020-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/0002512-200926020-00003

Keywords

Search

Navigation