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Prescribing for anxiety has increased in those aged under 35

12 April 2022

Researchers from the University of Bristol have found that there have been increases in incident prescribing of most anti-anxiety medications (called anxiolytics) in recent years, which have been substantial in young adults (aged under 25).

This may reflect better detection of anxiety, increasing severity of symptoms, increasing acceptability of medication, or an earlier unmet need. While overall incident benzodiazepine prescribing has fallen over time, prescribing has increased in those aged under 35. In 2017, 44 per cent of benzodiazepine prescriptions were longer than the NICE recommended maximum of four weeks.

Some of this prescribing is not based on robust evidence of effectiveness, such as the use of beta-blockers, some may contradict guidelines, such as anti-psychotics, and there is limited evidence on the effect of taking antidepressants long-term. As such, there may be unintended harm.

Prior to this research, previous studies had found substantial increases in the prescribing of antidepressants for any indication, and for depression, over the past two decades. However, little was known about trends in the prescribing of anxiolytics (antidepressants, benzodiazepines, beta-blockers, anticonvulsants, antipsychotics) for the treatment of anxiety. Several changes may have affected prescribing in recent years, including changes in clinical guidance.

Dr Charlotte Archer, an NIHR-funded Senior Research Associate in Primary Care Mental Health at the Centre for Academic Primary Care, University of Bristol, said: “The increases in the number of new patients starting anxiolytic treatment may reflect better detection of anxiety by GPs. The increase in new prescriptions was substantial in those aged 18-34, particularly in recent years, and this may also reflect an earlier unmet need for young adults.

“It is also important to consider that some of this prescribing is not based on robust evidence of effectiveness and some may contradict guidelines. There is also limited evidence on the effect of taking antidepressants long-term, so there may be unintended harm to those that are be being prescribed this medication for a long time.

“The information from this study has allowed us to gain a better understanding of primary care prescribing for anxiety, and how trends have changed over the study period. Going forward, we need research to improve our understanding of why we are seeing this increase in prescribing, especially in young adults, and to provide interventions that can reduce the growing reliance on medication for this age group.”

Paper: Rise in prescribing for anxiety in UK primary care between 2003 and 2018: a population-based cohort study using Clinical Practice Research Datalink by C Archer et al in The British Journal of General Practice (BJGP).

Listen to the BJGP podcast about this research.

Further information

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

Follow us on Twitter: @capcbristol

About the National Institute for Health Research (NIHR)

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care;
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

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