New Study Finds Antidepressant Medications May Delay a Worker’s Ability to Return to Work after an Injury

When a worker is injured on the job, there are many factors that can affect that individual’s ability to return to work. According to a 2016 study from the National Center for Biotechnology Information, everything from socioeconomic status and age to optimism and self-efficacy levels can have an impact. A new study from the Journal of Occupational and Environmental Medicine identifies yet another piece of the puzzle: antidepressant medication prescriptions.

The research, conducted by national insurance provider AF Group in partnership with researchers from the Johns Hopkins University School of Medicine, analyzed over 22,000 work-related indemnity claims from 2008 to 2013 from multiple states. It showed that when on-the-job injuries are treated alongside chronic pain, depression, and/or anxiety, large increases in total workers’ compensation claim costs and delayed return to work are more likely.

While previous studies have identified a relationship between opioid prescriptions and increased claim duration and higher medical costs, this study focused on the impact of
benzodiazepines (tranquilizers like Xanax and Valium) and antidepressants in combination with opioids on the same factors. Researcher Dr. Dan Hunt, medical director at AF Group, says some elements of the results were unanticipated.

“The overall direction of our findings was expected — injured workers who are experiencing a significant amount of pain or suffering from depression or anxiety will require more medical services than injured workers not experiencing such symptoms or psychosocial disorders,” said Dr. Hunt. “What did surprise us is the increased recovery time and medical costs associated with antidepressant medications.”

The combining of medications seems to have the most significant effect. The longest workers’ compensation insurance claim durations were associated with patients who had been prescribed all three medications: benzodiazepines, antidepressants, and opioids. The claim closure rate for those patients was 58.3% — when benzodiazepines were taken out of the equation, the rate was 64.8%. The number jumps to almost 89.1% when only opioids were prescribed, while no prescriptions brought the closure rate to 91.8%.

Of all the medications, the presence of antidepressants made the biggest difference. Even when controlling for age, chronic pain, and other factors, patients who were prescribed antidepressants were more likely to have open claims at the end of the three years the study was conducted. And those claims were more expensive, too, compared with all other classes of drugs.