The following is a summary of “National patterns of paroxetine use among US Medicare patients from 2015–2020,” published in the July 2024 issue of Psychiatry by Cavanah et al.
Paroxetine is an older “selective” serotonin reuptake inhibitor (SSRI) known for its lack of selectivity, leading to anticholinergic side effects, especially in adults aged 65 and older.
Researchers conducted a retrospective study analyzing paroxetine prescription rates and costs per state using Medicare data.
They used Medicare Specialty Utilization and Payment Data to examine paroxetine prescription rates and costs per state. States with annual prescription rates per thousand Part D enrollees outside a 95% CI were considered significantly different from the average.
The results showed that from 2015-2020, there was a national decrease in paroxetine prescriptions (-34.52%) and spending (-29.55%), but significant differences persisted between states were noticed. Kentucky had notably higher prescription rates (194.9, 195.3, 182.7, 165.1, 143.3, 132.5), while Hawaii had significantly lower rates (42.1, 37.9, 34.3, 31.7, 27.7, 26.6). North Dakota frequently had elevated prescribing rates (2016: 170.7, 2018: 143.3). Neuropsychiatry and geriatric medicine were the top prescribers of paroxetine relative to the number of providers from 2015-2020.
Investigators concluded that despite recommendations against paroxetine use in older adults, this remained commonly prescribed, particularly in Kentucky and North Dakota, and by neuropsychiatry and geriatric medicine. These insights highlighted where education and policy reform could improve prescription guideline adherence.
Source: frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1399493/abstract
