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Long term Effects of taking benzodiazepines

Qian He, Xiaohua Chen, Tang Wu, Liyuan Li, Xiaofan Fei
BACKGROUND AND PURPOSE: There is conflicting evidence in the literature on the association between benzodiazepines (BDZs) and the risk of dementia. This meta-analysis aimed to determine the relationship between the long-term usage of BDZs and the risk of dementia. METHODS: The PubMed and Embase databases were systematically searched for relevant publications up to September 2017. The literature search focused on observational studies that analyzed the relationship between the long-term use of BDZs and the risk of dementia...
October 26, 2018: Journal of Clinical Neurology
Uwe Verthein, Silke Kuhn, Rüdiger Holzbach, Aliaksandra Mokhar, Jörg Dirmaier, Martin Härter, Jens Reimer
BACKGROUND: Long-term use of benzodiazepines (BZD) and Z-drugs is associated with the risk of developing dependency. Many older patients use these drugs for long durations, which is often associated with low-dose dependency without an increase in dose. AIM: The aim of this study is to investigate the reasons, symptoms, and side effects, as well as the prescription conditions among older patients who were prescribed BZD or Z-drugs within the last 12 months. METHODS: A 9-page questionnaire was sent to 4,000 patients of the AOK-NordWest, stratified according to age group (50-56 years;>65 years) and intake behavior (long-term use/ guideline incompatible; short-term use/ guideline compatible)...
October 24, 2018: Das Gesundheitswesen
Susanne Rösner, Christian Englbrecht, Renate Wehrle, Göran Hajak, Michael Soyka
BACKGROUND: Insomnia is a major public health issue affecting between 6% to 10% of the adult population in Western countries. Eszopiclone is a hypnotic drug belonging to a newer group of hypnotic agents, known as new generation hypnotics, which was marketed as being just as effective as benzodiazepines for this condition, while being safer and having a lower risk for abuse and dependence. It is the aim of the review to integrate evidence from randomised controlled trials and to draw conclusions on eszopiclone's efficacy and safety profile, while taking methodological features and bias risks into consideration...
October 10, 2018: Cochrane Database of Systematic Reviews
Jeffrey Guina, Brian Merrill
Benzodiazepines are some of the most commonly prescribed medications in the world. These sedative-hypnotics can provide rapid relief for symptoms like anxiety and insomnia, but are also linked to a variety of adverse effects (whether used long-term, short-term, or as needed). Many patients take benzodiazepines long-term without ever receiving evidence-based first-line treatments (e.g., psychotherapy, relaxation techniques, sleep hygiene education, serotonergic agents). This review discusses the risks and benefits of, and alternatives to benzodiazepines...
January 30, 2018: Journal of Clinical Medicine
Jenna D Picton, Adriane Brackett Marino, Kimberly Lovin Nealy
PURPOSE: Published evidence on the relationship between benzodiazepine exposure and altered cognition in the geriatric population is reviewed. SUMMARY: Benzodiazepines constitute one of the most commonly prescribed medication classes and are used primarily for management of anxiety and insomnia. Despite strong recommendations based on high-quality evidence warning of the potential cognitive adverse effects of benzodiazepine use, particularly in patients 65 years of age or older, published literature suggests that a substantial proportion of the U...
January 1, 2018: American Journal of Health-system Pharmacy: AJHP
Takeo Hata, Tetsufumi Kanazawa, Takeshi Hamada, Masami Nishihara, Ashley Ian Bush, Hiroshi Yoneda, Miki Nakajima, Takahiro Katsumata
Although benzodiazepines (BZDs) are commonly prescribed for insomnia or anxiety, long-term use of BZDs causes serious adverse effects such as daytime drowsiness and cognitive decline. In the current study, we evaluated the predictors and preventers of long-term usage of BZDs from a retrospective survey by utilizing the 12-year prescription record of a university hospital. From the prescription data of 92,005 people, users of BZDs (n = 3,470, male = 39.2%, mean age = 60 ± 17.5) were analyzed. During this period, both the number of prescriptions (2722 in 2004 to 1019 in 2016) and the number of BZDs (1...
February 2018: Journal of Psychiatric Research
Guillaume Fond, F Berna, L Boyer, O Godin, L Brunel, M Andrianarisoa, B Aouizerate, D Capdevielle, I Chereau, J M Danion, C Dubertret, J Dubreucq, C Faget, F Gabayet, T Le Gloahec, P M Llorca, J Mallet, D Misdrahi, R Rey, R Richieri, C Passerieux, C Portalier, P Roux, A Vehier, H Yazbek, F Schürhoff, E Bulzacka
OBJECTIVE: The effect of benzodiazepine long-term administration (BLTA) in cognitive functioning of subjects with schizophrenia (SZ) has been partially explored to date. The objective was to assess BLTA-associated cognitive impairment with a comprehensive cognitive battery in a non-selected multicentric/national community-dwelling sample of stabilized SZ subjects. METHOD: 407 community-dwelling stabilized SZ subjects were consecutively included in the FondaMental Academic Centers of Expertise for Schizophrenia Cohort (FACE-SZ)...
February 2018: European Archives of Psychiatry and Clinical Neuroscience
Barbara Farrell, Lisa Richardson, Lalitha Raman-Wilms, David de Launay, Mhd Wasem Alsabbagh, James Conklin
BACKGROUND: Although polypharmacy is associated with significant morbidity, deprescribing can be challenging. In particular, clinicians express difficulty with their ability to deprescribe (i.e. reduce or stop medications that are potentially inappropriate). Evidence-based deprescribing guidelines are designed to help clinicians take action on reducing or stopping medications that may be causing more harm than benefit. OBJECTIVES: Determine if implementation of evidence-based guidelines increases self-efficacy for deprescribing proton pump inhibitor (PPI), benzodiazepine receptor agonist (BZRA) and antipsychotic (AP) drug classes...
January 2018: Research in Social & Administrative Pharmacy: RSAP
Stephanie Sampson, Prakash Hosalli, Vivek A Furtado, John M Davis
BACKGROUND: Risperidone is the first new generation antipsychotic drug made available in a long-acting injection formulation. OBJECTIVES: To examine the effects of depot risperidone for treatment of schizophrenia or related psychoses in comparison with placebo, no treatment or other antipsychotic medication.To critically appraise and summarise current evidence on the resource use, cost and cost-effectiveness of risperidone (depot) for schizophrenia. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Register (December 2002, 2012, and October 28, 2015)...
April 14, 2016: Cochrane Database of Systematic Reviews
Fabrizio Rinaldi, Andrea Galbiati, Sara Marelli, Luigi Ferini Strambi, Marco Zucconi
Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is a common condition characterized by an irresistible urge to move the legs, concomitant with an unpleasant sensation in the lower limbs, which is typically relieved by movement. Symptoms occur predominantly at rest and prevail in the afternoon or evening. Treatment of patients with RLS/WED is indicated for those patients who suffer from clinically relevant symptoms. The management of mild forms of RLS/WED is mainly based on dopamine agonists (DA) therapy (including pramipexole and ropinirole) and α-2-δ calcium-channel ligand...
February 2016: Current Treatment Options in Neurology
M Brinkers, G Pfau, T Schilling, F Meyer
BACKGROUND: In Germany, more than one million people use benzodiazepines on a regular basis. The majority of them is older than 60 years and take low-dose benzodiazepines for sleep disorders. This does not necessarily induce tolerance, but may result in problems such as falling, seizures or delirium if benzodiazepines are discontinued or taken on a long-term basis. Therefore, benzodiazepines can be associated with problems before, during and after surgery, in particular in the elderly...
February 2016: Zentralblatt Für Chirurgie
Michael Liebrenz, Marcel Schneider, Anna Buadze, Marie-Therese Gehring, Anish Dube, Carlo Caflisch
BACKGROUND: High-dose benzodiazepine (BZD) dependence is associated with a wide variety of negative health consequences. Affected individuals are reported to suffer from severe mental disorders and are often unable to achieve long-term abstinence via recommended discontinuation strategies. Although it is increasingly understood that treatment interventions should take subjective experiences and beliefs into account, the perceptions of this group of individuals remain under-investigated...
2015: PloS One
Yuhai Zhang, Xiao-Hua Zhou, Dana H Meranus, Linbo Wang, Walter A Kukull
Benzodiazepine (BZD) use may be associated with dementia. However, differing opinions exist regarding the effect of BZDs on long-term changes in cognition. We evaluated the association between BZD use and cognitive decline in the elderly with normal cognition from the National Alzheimer's Disease Coordinating Center's Uniform Data Set. The study exposure, BZD use, was classified 2 ways: any-use [reported BZD use at a minimum of 1 Alzheimer's disease center (ADC) visit] and always-use (reported BZD use at all ADC visits)...
April 2016: Alzheimer Disease and Associated Disorders
Mathieu Collomb, Florence Sens, Stéphane Sanchez, Anne Jolivot, Christine Pivot, Laurent Juillard, Carole Paillet
BACKGROUND: Dialysis patients frequently have anxiety and sleeping disorders and that explains a benzodiazepine treatment. A significant proportion of dialysis patients are long-term users even though it is not recommended to take benzodiazepine for more than 3 months. Risks of such a use are well identified. Nephrologists frequently have to prescribe benzodiazepines. This prescription is complex and there are few studies regarding the factors of benzodiazepine use among this population...
July 2015: Néphrologie & Thérapeutique
Michael Liebrenz, Marie-Therese Gehring, Anna Buadze, Carlo Caflisch
BACKGROUND: Benzodiazepine withdrawal syndrome has been reported following attempts to withdraw even from low or therapeutic doses and has been compared to barbiturate and alcohol withdrawal. This experience is known to deter patients from future cessation attempts. Research on other psychotropic substances shows that the reasons and motivations for withdrawal attempts - as well as the experiences surrounding those attempts - at least partially predict future efforts at discontinuation as well as relapse...
2015: BMC Psychiatry
Guilhème Pérodeau, Émilie Grenon, Sébastien Grenier, Kieron O'Connor
OBJECTIVES: Our goal was to build a systemic model of chronic use among community-dwelling mature benzodiazepine (BZD) users. BZDs are commonly prescribed for symptoms of anxiety and/or insomnia despite their documented side effects over time. METHOD: We conducted in-depth interviews with 23 mature (50 years and over) users, 14 women and 9 men, as well as 9 general practitioners and 11 pharmacists. We chose the grounded theory approach for our analysis. RESULTS: Results yielded a systemic model of chronic BZD use, illustrating onset and maintenance of use, and taking into account individual life context, intervening conditions (e...
2016: Aging & Mental Health
Katrin Janhsen, Patrik Roser, Knut Hoffmann
BACKGROUND: Benzodiazepine abuse and dependence have been recognized and widely discussed for more than 40 years. With more than 230 million daily doses prescribed in Germany per year, the burden of reimbursement on the statutory health insurance carriers is high, albeit with a slight decline from year to year. At present, about 50% of all prescriptions in Germany are issued privately, even for patients who have statutory health insurance. METHODS: We selectively review the literature on the epidemiology and treatment of benzodiazepine dependence and abuse in Germany...
January 5, 2015: Deutsches Ärzteblatt International
Bernd Antkowiak
Genetic approaches have been successfully used to relate the diverse molecular actions of anesthetic agents to their amnestic, sedative, hypnotic, and immobilizing properties. The hypnotic effect of etomidate, quantified as the duration of the loss of righting reflex in mice, is equally mediated by GABAA receptors containing β2- and β3-protein subunits. However, only β3-containing receptors are involved in producing electroencephalogram (EEG)-patterns typical of general anesthesia. The sedative action of diazepam is produced by α1-subunit-containing receptors, but these receptors do not contribute to the drug's characteristic EEG-"fingerprint...
2015: Advances in Pharmacology
Meldon Kahan, Anita Srivastava, Sheryl Spithoff, Lisa Bromley
OBJECTIVE: To offer preliminary guidance on prescribing smoked cannabis for chronic pain before the release of formal guidelines. QUALITY OF EVIDENCE: We reviewed the literature on the analgesic effectiveness of smoked cannabis and the harms of medical and recreational cannabis use. We developed recommendations on indications, contraindications, precautions, and dosing of smoked cannabis, and categorized the recommendations based on levels of evidence. Evidence is mostly level II (well conducted observational studies) and III (expert opinion)...
December 2014: Canadian Family Physician Médecin de Famille Canadien
Melita J Giummarra, Stephen J Gibson, Amy R Allen, Anne Sophie Pichler, Carolyn A Arnold
OBJECTIVE AND DESIGN: Individuals seeking treatment for chronic pain in multidisciplinary pain management services are typically already on high doses of pain medications. This cross-sectional cohort study of patients with long-term chronic pain examined profiles of polypharmacy and pain medication-related harm exposure. SETTING: Multidisciplinary pain management service. SUBJECTS: The cohort comprised 224 patients taking medications for their pain (1-9 medications; mean = 3...
March 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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