A programme for short‐term withdrawal from benzodiazepines in geriatric hospital inpatients: success rate and effect on subjective sleep quality

Petrovic, Mirko; Pevernagie, Dirk; Noortgate, Nele Van Den; Mariman, Ann; Michielsen, Walter; Afschrift, Marcel

doi:10.1002/(sici)1099-1166(199909)14:9<754::aid-gps15>3.3.co;2-5

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…After screening of the abstracts and if necessary the full text, 246 papers were excluded (Fig. 1) and 29 papers met the inclusion criteria (Tyrer et al , 1981; Lader & Olajide, 1987; Ashton et al , 1990; Cantopher et al , 1990; Jones, 1990; Udelman & Udelman, 1990; Garcia-Borreguero et al , 1991; Schweizer et al , 1991; Di Costanzo & Rovea, 1992; Lader et al , 1993; Otto et al , 1993; Bashir et al , 1994; Cormack et al , 1994; Schweizer et al , 1995; Tyrer et al , 1996; Lemoine et al , 1997; Hantouche et al , 1998; Garfinkel et al , 1999; Petrovic et al , 1999; Rickels et al , 1999, 2000; Cialdella et al , 2001; Zitman & Couvée 2001; Gerra et al , 2002; Vorma et al , 2002; Baillargeon et al , 2003; Oude Voshaar et al , 2003 a ; Rynn et al , 2003; Morin et al , 2004).…”

Section: Resultsmentioning

confidence: 99%

Strategies for discontinuing long-term benzodiazepine use

Voshaar

Couvée

Balkom³

et al. 2006

Br J Psychiatry

186

110

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Section: Resultsmentioning

confidence: 99%

Strategies for discontinuing long-term benzodiazepine use

Voshaar

Couvée

Balkom³

et al. 2006

Br J Psychiatry

186

110

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“…Agitation, anxiety, dysphoria, increased awareness of sensory stimuli, perceptual disturbances, depersonalisation, confusion, delirium and seizures are symptoms of withdrawal [70]. Elderly patients who are habituated to a low dose of benzodiazepines may be tapered in a short period of time if the initial phase of dose reduction is accompanied by psychological support [71]. Symptoms of withdrawal in the elderly may be different from those seen in younger patients.…”

Section: Withdrawalmentioning

confidence: 99%

Safety of benzodiazepines in the geriatric population

Madhusoodanan¹,

Bogunovic²

2004

Expert Opinion on Drug Safety

174

104

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Benzodiazepines are the most frequently prescribed antianxiety drugs in the elderly. Despite their usefulness and safety in the younger population, there is concern about the rationale for their use in the elderly. Studies of the therapeutic use of benzodiazepines in the elderly are rare. Elderly females with co-morbid medical and psychiatric conditions and who are taking multiple medications form the group most frequently prescribed benzodiazepines among the elderly, and the group most likely to experience side effects. Age-related pharmacokinetic and pharmacodynamic changes increase the potential for certain side effects in the elderly. Significant adverse effects that may be associated with benzodiazepine use in the elderly include falls, cognitive impairment, sedation, and impairment of driving skills, all of which are particularly related to the long half-life of benzodiazepines. Long-term use of benzodiazepines should be discouraged because of the risk of dependence, which is a serious problem in the elderly. Unrecognised and untreated benzodiazepine dependence can lead to serious medical complications.

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“…To our knowledge, this was the rst study of this magnitude investigating hypnotic discontinuation in this subset of the geriatric population. Second, our de nition of chronic hypnotic drug use was relatively short compared to previous reports [25,[35][36][37]. We deliberately chose this de nition because guidelines speci cally recommend to limit BZD or Z-drug use to maximally four weeks [38].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Hypnotic Discontinuation One Month After Discharge from an Acute Geriatric Ward: A Prospective, Observational Study

Brantegem

Liesenborghs

Hias

et al. 2020

Preprint

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BackgroundDeprescribing long-term hypnotic drug use is recommended in older adults to reduce medication-related harm such as falls. It is currently unknown whether this might be feasible in geriatric inpatients. The aim of this study was hence to determine predisposing factors for discontinuation of benzodiazepines and Z-drugs one month after discharge in geriatric inpatients receiving usual care.MethodsA prospective observational study was performed at the University Hospitals Leuven (UZ Leuven, Belgium). Patient characteristics, hypnotic drug use and sleep quality were gathered up to one month after discharge. A multivariable logistic regression model was used to identify independent determinants.ResultsChronic hypnotic drug use was highly prevalent (26.6%) in the geriatric population of UZ Leuven. Ninety-six patients with a mean age of 85.7 (SD 4.7) years admitted to the acute geriatric ward over a period of 10 months were included for analysis. Upon admission, 74% used a benzodiazepine and 26% a Z-drug. One month after discharge, 35 patients (36.5%) discontinued the hypnotic drug and in 23 cases (24.0%) the equivalent daily dose was reduced. Cessation of the hypnotic drug during hospitalization was found to be the only determinant influencing discontinuation one month after discharge with an odds ratio of 9.43 (95% confidence interval: 3.23 – 32.13). This was not associated with any deterioration of sleep quality.ConclusionsThis study confirms the overuse of long-term BZD and Z-drug use in geriatric patients. Cessation of hypnotic drugs during hospitalization was strongly associated with persistent discontinuation one month after discharge.Trial registrationThe study was approved by the Ethics Committee of UZ Leuven (registration number B322201629331).

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A programme for short‐term withdrawal from benzodiazepines in geriatric hospital inpatients: success rate and effect on subjective sleep quality

Abstract: Short-term withdrawal of BZD may be achieved in two-thirds of elderly hospital inpatients without deterioration of sleep quality or other deleterious side-effects.

Cited by 5 publications

References 12 publications

Strategies for discontinuing long-term benzodiazepine use

Strategies for discontinuing long-term benzodiazepine use

Safety of benzodiazepines in the geriatric population

Determinants of Hypnotic Discontinuation One Month After Discharge from an Acute Geriatric Ward: A Prospective, Observational Study

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