Does initial use of benzodiazepines delay an adequate pharmacological treatment? A multicentre analysis in patients with psychotic and affective disorders

Abstract

It is established that delayed effective pharmacotherapy plays a significant role in the overall burden of psychiatric disorders, which are often treated with symptomatic drugs, that is benzodiazepines (BZDs), in relation to their rapid onset of action and safety, despite long-term side effects. We aimed to assess the influence of initial treatment with BZDs on the duration of untreated illness (DUI) and whether specific sociodemographic and clinical factors could influence the choice of BZDs as first treatment in 545 patients affected by schizophrenia, mood and anxiety spectrum disorders. Statistical analyses (one-way analysis of variance and χ) were carried out to compare patients who used BZDs as first treatment (BZD w/) and those who did not (BZD w/o). The overall DUI, irrespective of diagnosis, resulted in significantly longer in BZD w/ versus w/o patients, who also experienced more frequently anxious/depressive symptoms at onset. Furthermore, BZD w/ patients more frequently autonomously decided to look for treatment (mainly refering to psychologists or general practitioners) and experimented more frequently phobias, than BZD w/o ones. The present findings suggest that initial BZDs treatment may prolong the overall DUI, although their prescription seems to be influenced by specific sociodemographic and clinical factors. Further studies are needed to confirm the present findings.

Latency to selective serotonin reuptake inhibitor vs benzodiazepine treatment in patients with panic disorder: a naturalistic study

“…This finding indicates that, despite the guideline recommendations, BDZs continue to be widely prescribed as first treatment in PD, 29 even though existing evidence suggests that long-term BDZ prescription might delay proper treatment in patients with mood and anxiety disorders, including PD. 56,57 Finally, we compared latency to SSRI treatment with findings from previous studies and observed some significant differences. The longer DUI in the present study could reflect a longer latency to treatment in patients with PD, but may be influenced by the setting of our study: all participants were undergoing CBT treatment, and may have been more inclined to access a nonpharmacological intervention.…”

Dependence on hypnotics: a comparative study between chronic users of benzodiazepines and Z-drugs

“…Nevertheless, the use of BZD often continues while the antidepressant does not, 41,44 increasing the duration of untreated illness. 45 A greater concern with medication availability and greater insomnia severity increased the chance of being diagnosed with dependence. However, this model had low discriminatory potential.…”

“…Nevertheless, the use of BZD often continues while the antidepressant does not, 41 , 44 increasing the duration of untreated illness. 45 …”

The Management of Prodromal Symptoms of Bipolar Disorder: Available Options and Future Perspectives

“…Anxiety symptoms may precede or co-occur with depressive and sub-syndromic hypomanic symptoms and are associated with future poor treatment response. Especially at the onset, anxious prodromes in patients at high risk of developing BD might be underestimated and often are treated exclusively with symptomatic drugs [16,79].…”

“…Benzodiazepines (BZDs) provide fast relief in the reduction of comorbid anxiety and are approved by Canadian Network for Mood and Anxiety Treatments as symptomatic drugs in the short-term treatment in BD; however, the appropriateness of their use in at-risk patients for BD is debated. Two recent works [79,90] asserted that prolonged use of BZDs in at-risk populations may extend the duration of untreated illness up to four years, delaying the administration of an adequate psychopharmacological treatment and an appropriate medical follow-up. The risk of drug misuse and dependence in BD patients appears higher than in other patients.…”