A Nation on Xanax?

No, I’m not picking on one drug or drug manufacturer here. However, an FDA advisory panel has found the need for screening of all Americans under the age of 65 for anxiety.(1)

The U.S. Preventive Services Task Force seeks comments on a draft recommendation statement and draft evidence review on screening for anxiety in adults. The Task Force determined that screening can help identify anxiety in adults younger than 65, including those who are pregnant and postpartum. More research is needed to recommend for or against screening for anxiety in adults older than 65. The draft recommendation statement and draft evidence review are available for review and public comment from September 20, 2022 to October 17, 2022 here

https://uspreventiveservicestaskforce.org/uspstf/announcements/public-comment-draft-recommendation-statement-and-draft-evidence-review-screening-anxiety-adults (2)

Currently, 25% of men and up to 40% of women have been diagnosed with anxiety disorders. The gender difference probably is misleading. Healthcare professionals have been aware for several years of a gender bias in diagnosing anxiety disorders.(3) In simplest form, some men may be more reluctant to report what they see as “feminine” symptoms or signs of weakness. The difficulty in getting a patient to address symptoms in a straight forward manner is similar to the challenges facing health professionals in dealing with allied illnesses such as PTSD.

If the hypothesis that far more men are subject to anxiety disorders than have been diagnosed, then the obvious conclusion is that anxiety is a far more common issue than has been recognized. In that context universal screening makes sense.

As discussed in a prior post, an MRI-based study showed that Covid-19 can damage areas of the frontal lobe of the brain that are responsible for decision making and control of emotions. That’s regardless of actual Covid symptoms. We have no clue about the proportion of the population affected by that.

However, the screening recommendation leads to several interesting questions:

  • Why does the screening recommendation cut off at age 65? Are we assuming that older people don’t matter? Or are we assuming that anyone with high levels of anxiety will have died by that age?
  • Why is the recommendation written as one-size fits all? It would seem that persons in high stress occupations – first responders, military, healthcare – should get priority attention? It’s hard to imaging that anxiety is uncorrelated with stress, but I suppose its possible.
  • While there are alternative therapies for anxiety, there are also a lot of medications on the marketplace to treat anxiety, With the incidence levels mentioned, is it possible that we will get to a place in which have of the US population is on anxiety drugs?
  • How to we screen the proportion of the US population without health insurance? There are a lot of them, not just undocumented immigrants, in places like Texas.

A nation on drugs may have been the dream of opioid manufacturers. They may just have focused on the wrong drug category.

Sources:

  1. https://apnews.com/article/science-health-covid-mental-b6bdfec54c16ff04ca18bba18000bbf9
  2. https://uspreventiveservicestaskforce.org/uspstf/
  3. https://pubmed.ncbi.nlm.nih.gov/33008537/
  4. https://pubmed.ncbi.nlm.nih.gov/18174499/
  5. https://www.psychiatrictimes.com/view/ptsd-valid-diagnosis-who-benefits-challenging-its-existence
Found online
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