Women and young adults propel huge rise in use of anti-anxiety drugs

Findings are based on analysis of care given to almost 2.6 million adults across UK from 2003 to 2018

The number of people in the UK using drugs to combat anxiety is soaring, driven by major increases among women and young adults, new research shows.

Women are more than twice as likely as men to be diagnosed with anxiety and prescribed medication including antidepressants to relieve its symptoms, the study found.

“It may be that women are more likely to seek help for anxiety, or are more willing to take medication for their mental health, and are therefore more likely to be prescribed anxiolytics [anti-anxiety drugs]”, said Dr Charlotte Archer, the study’s lead authory.

The finding that more women are diagnosed with and treated for anxiety mirrors the case with depression, added Archer, an academic at the University of Bristol’s medical school.

Her NHS-funded findings were published in the British Journal of General Practice on Tuesday. They are based on analysis by Archer and her colleagues of the care given to almost 2.6 million adults registered with 176 GP practices across the UK from 2003 to 2018, including 546,154 prescriptions for anxiolytics.

For every man using antidepressants, there are 2.26 women on them, 2.22 for Valium-like drugs called benzodiazepines, 2.33 for beta blockers and 2.19 for anticonvulsants.

“Even those drugs less frequently prescribed for more severe anxiety, like the antipsychotics, are more likely to be prescribed for women,” said Archer.

Use of anti-anxiety medication was steady between 2003 and 2008 but then began rising – possibly because of hardship due to the financial crash that year, she said.

The number of new prescriptions issued for anxiety rose from 25 or 26 per 1,000 person years at risk – a measure of the prevalence of anxiety – during that period to 43.6 in 2018.

The study found that the biggest rises in prescription of anti-anxiety drugs after that were in 25- to 34-year-olds, closely followed by under-25s and those aged 35 to 44.

That could reflect better detection of anxiety, the increasing severity of symptoms or the growing acceptability of using medication to treat the condition, she said.

However, the “substantial” rise in new diagnoses of anxiety among 18- to 35-year-olds is likely to be the result of individuals having been refused case from NHS child and adolescent mental health services (Camhs) when they were under 18, Archer suggested.

“For example, in 2018-19 over a quarter of referrals to Camhs were rejected, potentially leading to an increase in prescribing amongst the youngest age group [studied].”

Prof Martin Marshall, chair of the Royal College of GPs, said the proven effectiveness of antidepressants meant the rise in their use “should not be a cause for alarm”.

He added: “Indeed, it is most likely to suggest that more people are seeking medical help for anxiety for anxiety-related conditions, as well as improvement in the identification and diagnosis of them.”

A key reason more women are prescribed drugs for anxiety than men is that “women are more comfortable seeking help for mental health conditions”.

Men are less likely to request treatment for the condition than women “because of the stigma associated with poor mental health”, he added.

Archer warned that some people with anxiety are likely to be suffering “unintended harm” as a result of being prescribed drugs for which there is scant evidence that they work, such as beta blockers, or which contradict clinical guidelines, such as antipsychotics, or which may not be effective if taken long-term, such as antidepressants.

The new research does not capture the impact of the Covid pandemic, which has led to a growing number of people presenting at their GP surgery with mental health problems, Marshall added.

He called for NHS mental health care to be improved so that more people can access therapy rather than taking drugs.

Contributor

Denis Campbell Health policy editor

The GuardianTramp

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