Web searches for anxiolytic drugs during the COVID-19 outbreak in the USA

Several lines of evidence attest that the ongoing coronavirus disease 2019 (COVID-19) pandemic is accompanied by a vast array of physiological problems in the community. Since the emergence or magnification of anxiety disorders in the general population has also been suggested during the COVID-19 outbreak, we aimed to provide further insights on this matter by performing an electronic search in Google Trends (Google Inc, Mountain View, CA, USA), using the terms corresponding to the most common anxiolytic medicines used in the USA (ie, ‘Alprazolam’, ‘Diazepam’, ‘Lorazepam’, and ‘Clonazepam’) along with their brand names (‘Xanax’, ‘Valium’, ‘Ativan’, and ‘Klonopin’, respectively), and setting the country option to ‘United States’. The weekly Google Trends score recorded for each of the keywords after the emergence of the COVID-19 outbreak in the USA (ie, between 19 January to 18 November 2020) was compared with the average score recorded during each corresponding week of the previous 4 years (ie, between 19 January 2016 to 8 November 2019). The overall number of new weekly diagnoses of COVID-19 in the USA was also retrieved from the US Centres for Disease Control and Prevention (CDC) website. Comparison between the Google Trends scores before and after the emergence of the COVID-19 outbreak in the USA was carried out with the MannWhitney U test, while the correlation between new weekly cases of COVID-19 and the volume of Google searches for the four keywords during the same week of the year was analysed with Spearman’s correlation. The statistical analysis was carried out using Analyseit (Analyseit Software Ltd, Leeds, UK). The study was conducted in accordance with the Declaration of Helsinki, under the terms of relevant local legislation. The analysis was based on electronic searches in open, publicly available repositories, and thereby no informed consent or ethical committee approvals were required. The trend of the volume of weekly Google searches for the four keywords and the number of new weekly cases of COVID-19 in the USA are summarised in figure 1. A clear trend towards a reduction in weekly Google searches for the four anxiolytics could be observed throughout the study period, such that the Google Trends scores for all four drugs were found to be lower during the 43 weeks of the COVID-19 outbreak in the USA than in the corresponding weeks of the previous 4 years. More specifically, the weekly Google Trends score of alprazolam decreased from an average of 68.3±8.7 during the last 4 years to 50.6±3.0 in 2020 (−25.9%; p<0.001), that of diazepam Letter