posted on 2023-02-14, 05:12authored byMasahiro Takeshima, Yumi Aoki, Kenya Ie, Eiichi Katsumoto, Eichi Tsuru, Takashi Tsuboi, Ken Inada, Morito Kise, Koichiro Watanabe, Kazuo Mishima, Yoshikazu Takaesu
Introduction<p>Benzodiazepines and non-benzodiazepines are still widely prescribed despite safety concerns and the introduction of novel hypnotics (orexin receptor antagonists [ORA] and melatonin receptor agonists [MRA]), which may be influenced by physicians’ attitudes toward hypnotics.</p>Methods<p>A questionnaire survey was administered to 962 physicians between October 2021 and February 2022, investigating frequently prescribed hypnotics and the reasons for their selection.</p>Results<p>ORA were the most frequently prescribed at 84.3%, followed by non-benzodiazepines (75.4%), MRA (57.1%), and benzodiazepines (54.3%). Compared to non-frequent prescribers of hypnotics, a logistic regression analysis showed that frequent ORA prescribers were more concerned with efficacy (odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.01–2.54, p = 0.044) and safety (OR: 4.52, 95% CI: 2.99–6.84, p < 0.001), frequent MRA prescribers were more concerned with safety (OR: 2.48, 95% CI: 1.77–3.46, p < 0.001), frequent non-benzodiazepine prescribers were more concerned with efficacy (OR: 4.19, 95% CI: 2.91–6.04, p < 0.001), and frequent benzodiazepine prescribers were more concerned with efficacy (OR: 4.19, 95% CI: 2.91–6.04, p < 0.001) but less concerned with safety (OR: 0.25, 95% CI: 0.16–0.39, p < 0.001).</p>Discussion<p>This study suggested that physicians believed ORA to be an effective and safe hypnotic and were compelled to prescribe benzodiazepine and non-benzodiazepine frequently, choosing efficacy over safety.</p>