OBJECTIVES :

Anxiety disorders including generalized anxiety disorder, panic disorder, obsessive compulsive disorder, depressive anxiety, post-traumatic stress disorder (PTSD), and others, affect almost 20% of the U.S. population though only treated in around 35% of cases. This study explores the demographic and clinical characteristics of patients with anxiety disorders in the U.S. and the treatment patterns of these disorders through anti-anxiety medications.

METHODS :

De-identified electronic health records (EHR) of adult patients who were diagnosed with an anxiety disorder and later initiated an anti-anxiety medication in 2017. Patients were required to have activity in 12 months post-initiation (n=147,675) to study results in the follow-up period.

RESULTS :

Most patients were female (67.5%) averaging 46 years old at index. The most common diagnoses were depression (37%) and sleep disorders (16.6%). Many patients were prescribed their index medication by a psychiatrist (41.5%). Almost half of patients initiated treatment on SSRIs (45.8%) while a large number also initiated on benzodiazepines (32.8%). A small portion (7.6%) of patients had a concomitant benzodiazepine prescription (Rx) and an opioid Rx at some point after index. Substance abuse disorders including opioid abuse was most common amongst males with PTSD (10%). Though not recommended for treatment, almost half of all PTSD patients had a Rx for benzodiazepines (47.6%) at some point in the follow-up period. In follow-up, 64.4% of all patients stopped their index medication within one year of their initiation date.

CONCLUSIONS :

Most patients in our study were females who initiated an anti-anxiety treatment regimen on a SSRI or benzodiazepine. This population has a burden of concurrent conditions such as depression and sleep disorders, as well as overlapping prescriptions. Furthermore, a large proportion of patients discontinued or switched away from their index regimen a year after their initiation, indicating an additional gap in care among patients with anxiety.