Abstract
Background
The use of sedatives or hypnotics and the recurrence of depression have not been adequately explored. This study investigated the roles of sedative-hypnotics in patients with major depressive disorder (MDD). Various characteristics of sedative-hypnotic use were tested as risk factors for recurrence.
Methods
Clinical records of 15,510 patients with major depressive disorder who prescribed selective serotonin reuptake inhibitors (SSR) during 1997–2009 were collected from the National Health Insurance Research Database (NHIRD). Cox proportional hazard regression models were used to analyze factors related to depression recurrence.
Results
The risk of MDD recurrence was lower for patients using SED/HYP with an indication of both anxiolytics and hypnotics (AHR = 0.66; 95% CI = 0.59–0.72) than for those using SED/HYP with an indication of anxiolytics only. AHR was slightly greater in current users than in recent users (AHR = 0.77; 95% CI = 0.72–0.83) and past users (AHR = 0.70; 95% CI = 0.67–0.74). There was a higher AHR of MDD recurrence in patients who used SED/HYP over 1 DDD in 1 month than those who used SED/HYP less than 1 DDD in 1 month, with the highest-dose users having the highest risk of MDD recurrence (AHR = 7.91; 95% CI = 6.86–9.11).
Conclusions
Patterns and characteristics of sedative-hypnotic use may affect depression recurrence. These findings should be considered by clinicians when combining sedative-hypnotics with antidepressant treatment.
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Data availability
Data are available from the National Health Insurance Research Database (NHIRD) published by Taiwan National Health Insurance Institute (NHRI). Due to legal restrictions imposed by the government of Taiwan in relation to the “Personal Information Protection Act,” data cannot be made publicly available. Requests for data can be sent as a formal proposal to the NHRI.
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Acknowledgements
This manuscript was corrected by Wallace Academic Editing.
Funding
This study was funded by Taipei Medical University Hospital (107TMU-TMUH-23).
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M.H. Chung and K.H. Chung designed the study. M.H. Chung acquired and analyzed the data, which T.Y. Lee also analyzed. K.H. Chung and T.Y. Lee wrote the article, which all authors reviewed. All authors approved the final version to be published and can certify that no other individuals not listed as authors have made substantial contributions to the paper.
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Ethical approval for this experiment was obtained from the Joint Institutional Review Board of Taipei Medical University (approval N201806011).
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Chung, KH., Lee, TY. & Chung, MH. Roles of sedative-hypnotics in patients with recurrent major depressive disorder: a nationwide population-based 14-year follow-up study in Taiwan. Psychopharmacology 238, 1553–1561 (2021). https://doi.org/10.1007/s00213-021-05786-y
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DOI: https://doi.org/10.1007/s00213-021-05786-y