Below is a summary of “National Patterns of Paroxetine Use Among U.S. Medicare Patients from 2015 to 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 and for causing anticholinergic side effects, particularly in adults aged 65 years and over.

Researchers conducted a retrospective study using Medicare data to analyze paroxetine prescription rates and costs by state.

They used Medicare Specialty Utilization and Payment Data to examine paroxetine prescription rates and costs by state. States with annual prescription rates per thousand Part D enrollees outside a 95% CI were considered significantly different from the average.

Results showed that there was a nationwide decline in paroxetine prescriptions (-34.52%) and spending (-29.55%) from 2015 to 2020, but significant differences remained across states. Kentucky had significantly 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 had frequently increased prescription rates (2016: 170.7, 2018: 143.3). Neuropsychiatry and geriatrics were the most common prescribers of paroxetine relative to the number of providers from 2015 to 2020.

The researchers concluded that despite recommendations against its use in older adults, paroxetine continues to be widely prescribed, particularly in Kentucky and North Dakota, and in neuropsychiatry and geriatrics. These findings highlighted where education and policy reforms could improve adherence to prescribing guidelines.

Source: frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1399493/abstract