New regulations regarding e-prescriptions may increase the risk of acute withdrawal syndromes in patients dependent on benzodiazepines or non-benzodiazepine hypnotics

Silczuk, Andrzej; Heitzman, Janusz

doi:10.12740/pp/115555

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…If the nurse suspects a patient is high-risk, then they should communicate with other providers and maybe even decrease the dose or change the frequency. Patients should be carefully monitored, especially considering the risk of withdrawal syndromes, and those medications should be withdrawn safely [ 27 ]. Such knowledge may enable more well-informed decisions that improve care for community-dwelling older adults.…”

Section: Discussionmentioning

confidence: 99%

Risk of Falls Associated with Long-Acting Benzodiazepines or Tricyclic Antidepressants Use in Community-Dwelling Older Adults: A Nationwide Population-Based Case–Crossover Study

Seo

Park

et al. 2022

IJERPH

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Background: Falls are common in older adults and increase in recent years. This study aimed to examine the risk of falls associated with long-acting benzodiazepines (BZDs) or tricyclic antidepressants (TCAs) use in community-dwelling older adults. Methods: A nationwide population-based case–crossover design was used. We screened information on 6,370,275 fall or fall fracture cases among community-dwelling elderly patients from the database of the national health insurance data warehouse in South Korea. We extracted the data of elderly patients who visited the hospital for a fall and were diagnosed with the first fall or fall fracture after prescription of long-acting BZDs (n = 1805) or TCAs (n = 554). The study used conditional logistic regression analysis to analyze the associations and stratified analysis by gender and age group to control for their confounding effects. Results: Risk of falls or fall fractures increased by more than two times after taking long-acting BZDs (odds ratio [OR] = 2.16; 95% confidence interval [CI] = 1.85–2.52) or TCAs (OR = 2.13; 95% CI = 1.62–2.83). The longer the prescription period of both, the higher the risk of falls or fall fractures was (≥49 days for long-acting BZDs vs. ≥ 56 days for TCAs). Conclusions: Long-acting BZDs or TCAs should be avoided or prescribed for a shorter duration based on these adverse effects. Health care providers should focus on fall prevention practices in older adults who take such drugs.

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Section: Discussionmentioning

confidence: 99%

Risk of Falls Associated with Long-Acting Benzodiazepines or Tricyclic Antidepressants Use in Community-Dwelling Older Adults: A Nationwide Population-Based Case–Crossover Study

Seo

Park

et al. 2022

IJERPH

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“…Benzodiazepines (BDZ) are a class of psychoactive drugs that have been widely used for the treatment of many medical conditions. The most common indications for the use of benzodiazepines include, among others, anxiety disorders, insomnia, alcohol withdrawal, and seizures [1,2]. They play an important role in the emergency management of acute seizures and status epilepticus.…”

Section: Introductionmentioning

confidence: 99%

“…The typical course of BDZ dependence consists of everyday use with a possible escalation of the dose to relieve withdrawal symptoms. In the case of dependence, BDZ detoxification is a primary treatment [2].…”

Section: Introductionmentioning

confidence: 99%

Atypical benzodiazepine misuse and withdrawal in patient with epilepsy: a case report

Piskorska

Silczuk

2020

Egypt J Neurol Psychiatry Neurosurg

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Background Benzodiazepines (BDZ) are a class of psychoactive drugs that have been widely used for the treatment of many medical conditions. In this paper, a case of an atypical pattern of diazepam dependence in a patient with epilepsy is presented. The article may be an interesting proposition for rational management in the treatment of benzodiazepine dependence in a patient with non-withdrawal and withdrawal seizures. Detoxification is used then to optimize neurological treatment. Case presentation A 52-year-old Caucasian male, diagnosed with epilepsy with partial complex, and rarely tonic-clonic seizures and benzodiazepine (diazepam) misuse, was admitted to a detoxification unit specialized to treat substance dependence. This patient presented an atypical schedule of substance misuse with a weekly dose of 40 to 45 mg of diazepam, taken once a week, every Saturday. The patient reported having a group of symptoms that usually preceded generalized seizures that were described as the “aura” manifesting as confusion, derealisation, anxiety, and difficulties in speaking. First Saturday after admission to the hospital, the first aura experience was reported, while diazepam level in serum was higher than usual, which was supporting also strong psychological background for withdrawal. On weekend days, 3 weeks after admission, when the patient was receiving 3 mg of diazepam daily, he developed a severe “aura.” The EEG showed no seizure activity. Two weeks later (again Friday to Saturday), the patient reported the occurrence of aura, the EEG recording showed paroxysmal discharges, generalized multiple spikes associated with slow waves, lasting about 30 s, accompanied by eyelid myoclonia and disturbed consciousness. A week later another aura developed that resolved spontaneously without a seizure. Twelve days later, diazepam was completely removed; the elimination of serum benzodiazepines took place. The patient did not report aura until the end of the stay and he was dismissed 5 weeks later. Conclusions The differential diagnosis of an aura can be challenging. Carefully proceed serum monitored elimination of benzodiazepines in epileptic patients may serve in safety benefits and helps to achieve detoxification goals. Hence, it is important to prevent, recognize, and treat benzodiazepine dependence in every patient and may improve epilepsy treatment outcome.

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New regulations regarding e-prescriptions may increase the risk of acute withdrawal syndromes in patients dependent on benzodiazepines or non-benzodiazepine hypnotics

Cited by 2 publications

References 16 publications

Risk of Falls Associated with Long-Acting Benzodiazepines or Tricyclic Antidepressants Use in Community-Dwelling Older Adults: A Nationwide Population-Based Case–Crossover Study

Risk of Falls Associated with Long-Acting Benzodiazepines or Tricyclic Antidepressants Use in Community-Dwelling Older Adults: A Nationwide Population-Based Case–Crossover Study

Atypical benzodiazepine misuse and withdrawal in patient with epilepsy: a case report

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