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TOPLINE:

California wildfires are associated with a significant increase in psychotropic medication prescriptions — including those for antidepressants, anxiolytics, and mood stabilizers — for people living in areas affected by the wildfires, new data shows. The findings underscore the need to address the mental health effects of climate change, investigators said.

METHODOLOGY:

• Investigators obtained information on outpatient drug claims from the Merative MarketScan Research Database for more than 7 million Californians living in proximity to the state's largest 25 wildfires that occurred between 2011 and 2018.
• Information about daily medication prescriptions was analyzed 6 weeks prior to the onset of a wildfire (determined by the first date of posting on X by an official local, state, or federal wildfire agency) and for 6 weeks after its start.
• Using information about statin prescriptions as a control category, investigators analyzed data on prescriptions for antidepressants, antipsychotics, anxiolytics, mood stabilizers, and hypnotics.

TAKEAWAY:

• A mean of 22% of participants had at least one psychotropic drug claim and 12% had a statin drug claim during the study period.
• The number of psychotropic prescriptions increased from 252,000 prefire to 255,300 during the wildfires, but statin use remained relatively unchanged.
• There was a significant increase in antidepressant prescriptions (rate ratio [RR], 1.04; 95% CI, 1.01-1.07), anxiolytics (RR, 1.05; 95% CI, 1.02-1.09), and mood-stabilizing medications (RR, 1.06; 95% CI, 1.01-1.13) in the fire period compared with the prefire baseline.
• There was no association with wildfires and an increase in prescriptions of antipsychotics, hypnotics, or statins.

IN PRACTICE:

"The importance of clinical and public health efforts that shed light on negative mental health consequences is underscored by climate change and its role in increasing the frequency, intensity, and extent of wildfires and other environmental hazards, potentially escalating mental health burdens worldwide," study authors wrote.

SOURCE:

Zachary S. Wettstein, MD, and Ambarish Vaidyanathan, PhD, both of the Climate and Health Program at the Centers for Disease Control and Prevention in Atlanta, Georgia, led the study, which was published online on February 26, in JAMA Network Open.

LIMITATIONS:

Since the study relied on commercial claims data, it likely underestimated the mental health impact of those using Medicaid or Medicare or those without insurance.

DISCLOSURES:

There was no funding information available, and there were no disclosures reported.