Skip to main content

ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Psychopharmacology
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1471457
This article is part of the Research Topic Safety and Side Effects of Psychotropic Medications, volume III View all 8 articles

Association between polypharmacy and the long-term prescription of hypnotics in Japan: A retrospective cross-sectional study

Provisionally accepted
Munehiro Komatsu Munehiro Komatsu 1Masahiro Takeshima Masahiro Takeshima 1*Kazuhisa Yoshizawa Kazuhisa Yoshizawa 1Masaya Ogasawara Masaya Ogasawara 1Mizuki Kudo Mizuki Kudo 1Eru Miyakoshi Eru Miyakoshi 1Yu Itoh Yu Itoh 1Nana Shibata Nana Shibata 1Naoko Ayabe Naoko Ayabe 2Kazuo Mishima Kazuo Mishima 1
  • 1 Graduate School of Medicine, Akita University, Akita, Japan
  • 2 Akita University, Akita, Akita, Japan

The final, formatted version of the article will be published soon.

    Introduction: Hypnotic polypharmacy and its long-term prescriptions constitute the inappropriate use of hypnotics. However, the relationship between hypnotic polypharmacy and prolonged prescriptions remains unclear. This study aimed to elucidate the association between hypnotic polypharmacy and the duration of hypnotic prescriptions. Methods: This retrospective, cross-sectional study utilized a large dataset from the Japan Medical Data Center. The study population included adults who had been prescribed hypnotics between April 2020 and March 2021, with a focus on those receiving hypnotics in March 2021. Hypnotic polypharmacy was defined as the concurrent prescription of two or more hypnotics in March 2021. The duration of hypnotic prescriptions was measured by calculating the number of months between April 2019 and March 2021 during which hypnotics were prescribed. A binary logistic regression analysis was conducted to assess the relationship between hypnotic polypharmacy and long-term hypnotic prescriptions, adjusting for relevant covariates. Results: We included 112,256 patients (mean age: 49.5 years, females: 47.1%). Among them, 67.9% received hypnotic monotherapy, and 32.1% received hypnotic polypharmacy. Compared with adults who were prescribed hypnotics for 1 month, the association with polypharmacy was stronger in those who were prescribed hypnotics for ≥4 months as the duration of the prescription increased (adjusted odds ratio [aOR]: 1.15, 95% confidence interval [CI]: 1.04–1.27, p=0.006 for 4–6 months; aOR 1.35, 95% CI 1.23–1.49, p<0.001 for 7–9 months; aOR 1.58, 95% CI 1.43–1.73, p<0.001 for 10–12 months; and aOR 3.24, 95% CI 2.99–3.52 for 13–24 months). Conclusions: This study demonstrated a significant association between hypnotic polypharmacy and long-term prescriptions of hypnotics. Initiating insomnia treatment with hypnotic monotherapy may reduce the likelihood of long-term prescriptions, and limiting the duration of hypnotic prescriptions could potentially prevent polypharmacy.

    Keywords: antidepressant, antipsychotic, anxiolytics, hypnotics, Polypharmacy, longterm prescription

    Received: 27 Jul 2024; Accepted: 29 Oct 2024.

    Copyright: © 2024 Komatsu, Takeshima, Yoshizawa, Ogasawara, Kudo, Miyakoshi, Itoh, Shibata, Ayabe and Mishima. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Masahiro Takeshima, Graduate School of Medicine, Akita University, Akita, Japan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.