Table 2.
Characteristics of Received Antidepressants and Major Psychotropic Medications by Buprenorphine Treatment Duration Among a Cohort Who Initiated Buprenorphine Treatment Between January 2016 and June 2017
| Buprenorphine treatment duration | |||||||
|---|---|---|---|---|---|---|---|
| Overall | 7–30 Days | 31–90 Days | 91–180 Days | 181–365 Days | >365 Days | P value | |
| (N = 11,619) | (N = 2,180) | (N = 1,731) | (N = 1,559) | (N = 2,478) | (N = 3,671) | ||
| Antidepressants | |||||||
| Status of antidepressant use, % | |||||||
| No antidepressants during buprenorphine treatment | |||||||
| No antidepressants at all | 44.3 | 50.0 | 46.2 | 44.7 | 44.7 | 39.4 | < .001 |
| Antidepressants only in 6 mo prior to treatment | 9.5 | 20.2 | 11.9 | 8.6 | 6.1 | 4.7 | < .001 |
| Antidepressants during buprenorphine treatment | |||||||
| Antidepressants only during treatment | 17.4 | 11.2 | 13.2 | 16.9 | 18.2 | 22.9 | < .001 |
| Antidepressants both in 6 mo prior to and during treatment | 28.8 | 18.6 | 28.7 | 29.8 | 31.0 | 33.0 | < .001 |
| Days’ supply of antidepressant use prior to buprenorphine treatment, mean (median) | |||||||
| Among antidepressants only in 6 mo prior to treatment | 76.1 (60) | 90.7 (85) | 74.6 (60) | 66.0 (60) | 61.0 (53) | 62.8 (53) | < .001 |
| Among antidepressants both in 6 mo prior to and during treatment | 118.3 (131) | 118.3 (128) | 117.1 (132) | 119.0 (130) | 118.4 (129) | 119.3 (135) | .970 |
| Average percent of total buprenorphine treatment days covered by antidepressants, % | |||||||
| All types of antidepressants | 31.0 | 26.0 | 29.7 | 30.6 | 30.4 | 35.0 | < .001 |
| Antidepressant type | |||||||
| SSRI (eg, escitalopram, sertraline, fluoxetine) | 13.8 | 8.0 | 12.8 | 13.4 | 13.9 | 17.7 | < .001 |
| SNRI (eg, duloxetine, venlafaxine, desvenlafaxine) | 6.8 | 4.1 | 5.8 | 7.8 | 7.0 | 8.2 | < .001 |
| TCA (eg, amitriptyline, doxepin, nortriptyline) | 2.5 | 2.9 | 2.6 | 2.7 | 2.1 | 2.5 | .192 |
| Other (eg, trazodone, bupropion, mirtazapine) | 13.3 | 15.3 | 13.1 | 12.0 | 12.3 | 13.3 | < .001 |
| Major psychotropic medications | |||||||
| Benzodiazepines, % | |||||||
| Any benzodiazepine | 35.5 | 38.0 | 34.4 | 34.8 | 36.0 | 36.0 | .074 |
| Any benzodiazepine prior to treatment | 27.4 | 32.0 | 29.0 | 27.6 | 26.5 | 24.6 | < .001 |
| Any benzodiazepine during treatment | 25.2 | 22.5 | 21.7 | 25.0 | 27.8 | 28.2 | < .001 |
| Percent of total eligible buprenorphine treatment days with benzodiazepines | 16.0 | 21.6 | 15.5 | 15.3 | 16.2 | 13.2 | < .001 |
| Opioid analgesics, % | |||||||
| Any opioid analgesic | 46.5 | 45.1 | 44.3 | 42.8 | 45.4 | 51.9 | < .001 |
| Any opioid analgesic prior to treatment | 42.0 | 44.3 | 42.6 | 40.0 | 40.0 | 43.3 | .001 |
| Any opioid analgesic during treatment | 17.4 | 13.3 | 13.7 | 14.8 | 18.3 | 24.7 | < .001 |
| Percent of total eligible buprenorphine treatment days with opioid analgesics | 6.7 | 16.3 | 9.1 | 5.9 | 3.5 | 2.3 | < 0.001 |
| Stimulants, % | |||||||
| Any stimulant | 13.6 | 10.8 | 12.7 | 13.0 | 15.4 | 15.8 | < .001 |
| Any stimulant prior to treatment | 9.7 | 10.1 | 10.7 | 9.4 | 10.2 | 8.8 | .147 |
| Any stimulant during treatment | 10.8 | 6.0 | 8.4 | 10.6 | 13.6 | 14.1 | < .001 |
| Percent of total eligible buprenorphine treatment days with stimulants | 8.2 | 6.9 | 7.2 | 7.7 | 10.1 | 8.5 | < .001 |
| Other psychotropic medications, % | |||||||
| Any other psychotropic | 41.0 | 41.3 | 42.5 | 40.0 | 39.8 | 43.9 | .375 |
| Any other psychotropic prior to treatment | 28.1 | 31.2 | 31.9 | 28.4 | 26.0 | 25.8 | < .001 |
| Any other psychotropic during treatment | 32.4 | 27.6 | 31.2 | 30.9 | 33.8 | 38.7 | < .001 |
| Percent of total eligible buprenorphine treatment days with other psychotropics | 22.3 | 28.9 | 25.4 | 21.2 | 20.1 | 19.0 | < .001 |
Abbreviations: SNRI = serotonin-norepinephrine reuptake inhibitor, SSRI = selective serotonin reuptake inhibitor, TCA = tricyclic antidepressant.