The Use of Pain, Depression, and Anxiety Drugs in Hemophilia

By Dr. David Clark

A 2023 study looked at pain, depression, and anxiety in hemophilia in Nordic countries by analyzing their use of medication.

Dr. David Clark

Pain has been widely studied in hemophilia, but anxiety and depression much less so. The government healthcare systems in those countries make this much easier because all of the patient data is centralized in registries, unlike the U.S.

They divided 3246 hemophilia patients (596 Bs, with or without inhibitors) into groups by factor consumption. For hemophilia B, the three groups were moderate-to-high (MTH) factor consumption (≥10 IU/kg/week), low factor consumption (LFC) and women.

The study found that overall, hemophilia patients used more pain, depression and anxiety medications than the controls (the general population without hemophilia). This was most accentuated in the MTH group, but also in males in the LFC group and in women. Opioid use in the MTH group was 4 - 6 times greater than in the controls, and 2 - 4 times greater in the LFC group, across all age groups.

The researchers conclude that this “suggests a need for improved bleed protection and hemophilia care for all severities, including mild hemophilia.” [Carlsson KS, et al., Res. Pract. Thromb. Haemost., 7(2):100061 (2023)]