In the month of March, the Spanish Agency for Medicines and Health Products (Aemps) published the report Consumption of anxiolytic and hypnotic drugs in Official Recipes and Mutuals . The data collected in the aforementioned study reflects a particularly significant increase in the use of these drugs since 2010 . In addition, two moments can be clearly seen in which this trend is significantly accentuated: one located between 2011 and 2012, and another very marked in 2020. These peaks correspond to some of the hardest moments of the economic crisis that started in 2008 , as well as the COVID-19 pandemic , respectively.
Experts agree that social situations that qualify as “complicated”, such as those mentioned above, added to family, social, work or economic situations that may arise in the individual sphere of each person, are a clear cause of discomfort that, in some cases, can lead to problems of anxiety or depression.
To control them, especially in the most acute phases, the use of medication is sometimes necessary. However, health professionals stress the need to have other human resources —such as psychologists— to reduce their use and provide patients with the tools to deal with these discomforts. At least, in the cases that it is possible.
patient follow-up
Guillermo Lahera, Full Professor of Psychiatry at the University of Alcalá de Henares and member of the Board of Directors of the Spanish Society of Psychiatry and Mental Health, points out that “ with the pandemic, an increase in anxiety and depression has been observed in the adult population and , strikingly, an increase in emergencies in adolescents, self-harm and eating disorders. This period led, as the expert explains, “many telephone visits to patients, with fundamentally pharmacological management of these disorders.”
Here, the expert points out that he especially highlights “the increase in anxiolytic and hypnotic-type medications , often used in the treatment of insomnia.”
Primary care is often the first point of contact for people who suffer from these clinical conditions. But experts point out that the problem is not the prescription of drugs, but the lack of other resources that complement drug therapy . Vicente Gasull, coordinator of the Mental Health Working Group of the Spanish Society of Primary Care Physicians (SEMERGEN) indicates that the ideal would be to have more psychology professionals, adding that “on many occasions what the patient needs is support of these types of professionals. Talk and put the situation in perspective, and learn coping techniques, which would lead to a reduction in the inappropriate use of these drugs.
It is not a question of “demonizing” the use of these drugs , as these doctors consider it, but of ensuring that there are human resources to carry out a correct follow-up in the cases that are prescribed. “Like many other drugs, when they are prescribed, they need to be controlled,” says Antonio Torres, head of the Mental Health Working Group of the Spanish Society of General and Family Physicians (SEMG).
Here, the doctor expresses that “it is curious that the antidepressant drugs have a worse reputation than anxiolytics or hypnotics, because the latter two are the ones that produce the greatest addiction and, in addition, antidepressants can be withdrawn more quickly.”
Lahera agrees with this idea, although she does qualify and clarify her colleague’s idea, stating that “its use must be temporarily limited, and always with the idea of withdrawal. However, in practice, many patients become chronic with its use, due to the reinforcement that its anxiolytic effect entails».
The withdrawal, a pending subject
With all this as context, Vicente Gasull points out that “monitoring the use of these drugs and ensuring their timely withdrawal is a pending issue.” And it is that, according to the expert, there are specific situations or circumstances that may go unnoticed, but in which the use of the aforementioned drugs is no longer justified.
“There are older people who have been taking anxiolytics for many years of their lives but do not increase doses. In these cases, what should be done is to rethink if it is really having an effect on them. To this is added that, specifically in the case of these older people, there are drugs that may be altering the balance, which increases the probability of suffering a fall and, therefore, of a hip fracture, for example. So, with the lack of benefit that it would have in the cases explained and the possible negative impact, Gasull urges a better analysis of each specific situation and avoid prolonged use of this type of medication. It is essential that it be analyzed individually.
It should be noted that this situation does not only affect the elderly. In fact, Torres adds that “there are studies that are far removed from purely scientific criteria that show that the use of these drugs has an influence, for example, on road traffic and accidents , as well as on occupational or domestic accidents.” For this reason, he urges to review “the use of these drugs in the long term, above all, due to the interactions that they can have in the lives of patients”.
