Major Depression and Sedative-Hypnotic Use Disorder: a Review

Abstract

Nonmedical use or addiction of sedative-hypnotics is commonly seen among patients with major depressive disorder (MDD). The aim of this article is to review the prevalence of, the relationship between, and the current treatment of MDD comorbid with sedative-hypnotic use disorder. Approximately 3–5% of general population is prescribed sedative-hypnotic medications and prescribing of these agents is more common in women and the elderly. About 2.3% of the US population reported using hypnotics nonmedically, with 0.6% reporting using sedatives nonmedically. Among these nonmedical sedative-hypnotic users, 9.8% met criteria for sedative use disorders. MDD was found to be associated with higher odds of sedative-hypnotics both in adult and adolescent population; however, very few studies examined specifically the prevalence of sedative-hypnotic use disorders in MDD patients. The main motive to misuse or abuse these medications is self-medication of sleep and anxiety problems. In addition, the relationship between MDD and sedative-hypnotic use disorders seems bidirectional. While MDD is a risk factor for the development of sedative-hypnotic use disorder, long-term use of these medications could lead to occurrence of MDD. Thus, it is crucial to offer integrated program that could treat both MDD and sedative-hypnotic use disorder simultaneously. Adequate treatment of MDD and earlier identification of sedative-hypnotic use problems are essential for the treatment of MDD with sedative-hypnotic use disorder. A more integrated treatment program that fulfills the need of patients with both mental and addiction problems should be developed and expanded.