Kerry L. Kinney , Eliseu da Cruz Moreira-Junior , Laís F. Berro , Matthew C. Morris , James K. Rowlett
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Patients were categorized into three groups: those co-prescribed an SSRI, those co-prescribed an SNRI, and those not co-prescribed an SSRI or SNRI.</div></div><div><h3>Results</h3><div>Individuals co-prescribed an SSRI (<em>M</em>=6.63) or an SNRI (<em>M</em>=8.31) had more benzodiazepine prescription encounters than those who were not co-prescribed an SSRI/SNRI (<em>M</em>=5.08). Individuals co-prescribed an SSRI or SNRI also received a higher maximum benzodiazepine dosage than those who were not co-prescribed an SSRI/SNRI (SSRI <em>M</em>=2.41; SNRI <em>M</em>=2.30; No SSRI/SNRI <em>M</em>=1.91 diazepam milligram equivalent defined daily doses). Multilevel models indicated the SSRI co-prescription group received a higher initial benzodiazepine dosage (<em>b</em>=0.394), but showed no significant change in benzodiazepine dosage over time. When controlling for demographic and clinical correlates of benzodiazepine prescriptions, those who were not co-prescribed an SSRI showed an increase in benzodiazepine dose over time (<em>b</em>=0.075). Multilevel models revealed no relationship between SNRI co-prescription and starting benzodiazepine dosage or change in benzodiazepine dosage over time. An anxiety disorder diagnosis, younger age, and non-Black/African American race were associated with higher benzodiazepine dose.</div></div><div><h3>Conclusions</h3><div>Individuals who are co-prescribed an SSRI/SNRI may be vulnerable to longer treatment durations and higher prescribed doses of benzodiazepines, raising concerns about risk for dependence among individuals receiving combined benzodiazepine and SSRI/SNRI treatment.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"15 ","pages":"Article 100325"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of SSRI and SNRI co-prescription on benzodiazepine prescription trajectories\",\"authors\":\"Kerry L. Kinney , Eliseu da Cruz Moreira-Junior , Laís F. Berro , Matthew C. Morris , James K. Rowlett\",\"doi\":\"10.1016/j.dadr.2025.100325\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>This study examined whether co-prescription of selective serotonin reuptake inhibitors (SSRIs) or serotonin or norepinephrine reuptake inhibitors (SNRI)s with benzodiazepines is associated with differences in benzodiazepine prescriptions both within individual patients over time and between patients.</div></div><div><h3>Methods</h3><div>We analyzed deidentified electronic health records of patients prescribed a benzodiazepine between 2020 and 2022 (<em>N</em> = 847). Patients were categorized into three groups: those co-prescribed an SSRI, those co-prescribed an SNRI, and those not co-prescribed an SSRI or SNRI.</div></div><div><h3>Results</h3><div>Individuals co-prescribed an SSRI (<em>M</em>=6.63) or an SNRI (<em>M</em>=8.31) had more benzodiazepine prescription encounters than those who were not co-prescribed an SSRI/SNRI (<em>M</em>=5.08). Individuals co-prescribed an SSRI or SNRI also received a higher maximum benzodiazepine dosage than those who were not co-prescribed an SSRI/SNRI (SSRI <em>M</em>=2.41; SNRI <em>M</em>=2.30; No SSRI/SNRI <em>M</em>=1.91 diazepam milligram equivalent defined daily doses). Multilevel models indicated the SSRI co-prescription group received a higher initial benzodiazepine dosage (<em>b</em>=0.394), but showed no significant change in benzodiazepine dosage over time. When controlling for demographic and clinical correlates of benzodiazepine prescriptions, those who were not co-prescribed an SSRI showed an increase in benzodiazepine dose over time (<em>b</em>=0.075). Multilevel models revealed no relationship between SNRI co-prescription and starting benzodiazepine dosage or change in benzodiazepine dosage over time. An anxiety disorder diagnosis, younger age, and non-Black/African American race were associated with higher benzodiazepine dose.</div></div><div><h3>Conclusions</h3><div>Individuals who are co-prescribed an SSRI/SNRI may be vulnerable to longer treatment durations and higher prescribed doses of benzodiazepines, raising concerns about risk for dependence among individuals receiving combined benzodiazepine and SSRI/SNRI treatment.</div></div>\",\"PeriodicalId\":72841,\"journal\":{\"name\":\"Drug and alcohol dependence reports\",\"volume\":\"15 \",\"pages\":\"Article 100325\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Drug and alcohol dependence reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772724625000083\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug and alcohol dependence reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772724625000083","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究探讨了选择性5 -羟色胺再摄取抑制剂（SSRIs）或5 -羟色胺或去甲肾上腺素再摄取抑制剂（SNRI）与苯二氮卓类药物的合用是否与个体患者和患者之间苯二氮卓类药物处方的差异有关。方法分析2020年至2022年服用苯二氮卓类药物患者的电子健康记录（N = 847）。患者被分为三组：联合服用SSRI的患者，联合服用SNRI的患者，以及未联合服用SSRI或SNRI的患者。结果合用SSRI组（M=6.63）或SNRI组（M=8.31）比未合用SSRI/SNRI组（M=5.08）有更多的苯二氮卓类药物处方遭遇。同时服用SSRI或SNRI的个体也比未服用SSRI/SNRI的个体获得更高的苯二氮卓类药物的最大剂量(SSRI M=2.41；SNRI M = 2.30;无SSRI/SNRI M=1.91地西泮毫克当量定义日剂量)。多水平模型显示，SSRI共处方组的苯二氮卓类药物初始剂量较高（b=0.394），但苯二氮卓类药物剂量随时间变化不显著。在控制了苯二氮卓类药物处方的人口学和临床相关因素后，未同时服用SSRI的患者苯二氮卓类药物剂量随时间增加（b=0.075）。多水平模型显示SNRI联合处方与苯二氮卓类药物起始剂量或苯二氮卓类药物剂量随时间的变化没有关系。焦虑障碍诊断、年龄较小、非黑人/非裔美国人种族与苯二氮卓类药物剂量较高相关。结论联合使用SSRI/SNRI的个体可能容易受到更长治疗时间和更高处方剂量的苯二氮卓类药物的影响，这增加了对接受苯二氮卓类药物和SSRI/SNRI联合治疗的个体依赖风险的担忧。
Influence of SSRI and SNRI co-prescription on benzodiazepine prescription trajectories
Purpose
This study examined whether co-prescription of selective serotonin reuptake inhibitors (SSRIs) or serotonin or norepinephrine reuptake inhibitors (SNRI)s with benzodiazepines is associated with differences in benzodiazepine prescriptions both within individual patients over time and between patients.
Methods
We analyzed deidentified electronic health records of patients prescribed a benzodiazepine between 2020 and 2022 (N = 847). Patients were categorized into three groups: those co-prescribed an SSRI, those co-prescribed an SNRI, and those not co-prescribed an SSRI or SNRI.
Results
Individuals co-prescribed an SSRI (M=6.63) or an SNRI (M=8.31) had more benzodiazepine prescription encounters than those who were not co-prescribed an SSRI/SNRI (M=5.08). Individuals co-prescribed an SSRI or SNRI also received a higher maximum benzodiazepine dosage than those who were not co-prescribed an SSRI/SNRI (SSRI M=2.41; SNRI M=2.30; No SSRI/SNRI M=1.91 diazepam milligram equivalent defined daily doses). Multilevel models indicated the SSRI co-prescription group received a higher initial benzodiazepine dosage (b=0.394), but showed no significant change in benzodiazepine dosage over time. When controlling for demographic and clinical correlates of benzodiazepine prescriptions, those who were not co-prescribed an SSRI showed an increase in benzodiazepine dose over time (b=0.075). Multilevel models revealed no relationship between SNRI co-prescription and starting benzodiazepine dosage or change in benzodiazepine dosage over time. An anxiety disorder diagnosis, younger age, and non-Black/African American race were associated with higher benzodiazepine dose.
Conclusions
Individuals who are co-prescribed an SSRI/SNRI may be vulnerable to longer treatment durations and higher prescribed doses of benzodiazepines, raising concerns about risk for dependence among individuals receiving combined benzodiazepine and SSRI/SNRI treatment.
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