PT - JOURNAL ARTICLE AU - Charlotte Archer AU - Stephanie J MacNeill AU - Becky Mars AU - Katrina Turner AU - David Kessler AU - Nicola Wiles TI - Rise in prescribing for anxiety in UK primary care between 2003 and 2018: a population-based cohort study using Clinical Practice Research Datalink AID - 10.3399/BJGP.2021.0561 DP - 2022 Jul 01 TA - British Journal of General Practice PG - e511--e518 VI - 72 IP - 720 4099 - http://bjgp.org/content/72/720/e511.short 4100 - http://bjgp.org/content/72/720/e511.full SO - Br J Gen Pract2022 Jul 01; 72 AB - Background Little is known about trends in prescribing of anxiolytics (antidepressants, benzodiazepines, beta-blockers, anticonvulsants, and antipsychotics) for treatment of anxiety. Several changes may have affected prescribing in recent years, including changes in clinical guidance.Aim To examine trends in prescribing for anxiety in UK primary care between 2003 and 2018.Design and setting A population-based cohort study using Clinical Practice Research Datalink (CPRD) data.Method Analysis of data from adults (n = 2 569 153) registered at CPRD practices between 2003 and 2018. Prevalence and incidence rates were calculated for prescriptions of any anxiolytic and also for each drug class. Treatment duration was also examined.Results Between 2003 and 2018, prevalence of any anxiolytic prescription increased from 24.9/1000 person-years-at-risk (PYAR) to 43.6/1000 PYAR, driven by increases in those starting treatment, rather than more long-term use. Between 2003 and 2006, incidence of any anxiolytic prescription decreased from 12.8/1000 PYAR to 10.0/1000 PYAR; after which incidence rose to 13.1/1000 PYAR in 2018. Similar trends were seen for antidepressant prescriptions. Incident beta-blocker prescribing increased over the 16 years, whereas incident benzodiazepine prescriptions decreased. Long-term prescribing of benzodiazepines declined, yet 44% of prescriptions in 2017 were longer than the recommended 4 weeks. Incident prescriptions in each drug class have risen substantially in young adults in recent years.Conclusion Recent increases in incident prescribing, especially in young adults, may reflect better detection of anxiety, increasing acceptability of medication, or an earlier unmet need. However, some prescribing is not based on robust evidence of effectiveness, may contradict guidelines, and there is limited evidence on the overall impact associated with taking antidepressants long term. As such, there may be unintended harm.