Benzodiazepine and cyclopyrrolone reduction in general practice - Does this lead to change in the use of antidepressants? A study based on a Danish population

BackgroundThe consumption of benzodiazepines and cyclopyrrolones has in recent years attracted considerable interest due to serious side effects. In twelve health care practices in Denmark a few simple rules to reduce the consumption were established. Telephone recipes were abolished, and prescriptions were issued for only a single month's usage and only following personal consultation. These rules are generally in accordance with recommendations applicable in, for example, England, Norway and Denmark. After 15 months, consumption was roughly halved.There is a general lack of knowledge about whether an intervention as described above leads to a substitution with other medicines. Here, especially antidepressants are in the spotlight.MethodsIn the twelve health care practices, the consumption of antidepressants before, during and after the intervention was followed.ResultsThe total consumption of antidepressants rose by 5.2% per year during the 18 month observation period. This should be compared to the fact that the county had an increase of 8.6% per year during the same period. This increase occurred mainly in the group of selective serotonin reuptake inhibitors.LimitationsThe study does not provide information about prescription changes for individual users, or for changes in the number of users. The study is limited to the total prescribed volume of antidepressants.ConclusionThe average prescription volume for the twelve health care practices corresponds to a relative decline. Fears that an intervention of the type mentioned above would lead to an uncontrollable increase in the consumption of antidepressants are unfounded.