Starting insomnia treatment: the use of benzodiazepines versus z-hypnotics. A prescription database study of predictors

Hausken, Anne Margrethe; Furu, Kari; Skurtveit, Svetlana; Engeland, Anders; Bramness, Jørgen G.

doi:10.1007/s00228-008-0565-8

Cited by 54 publications

(32 citation statements)

References 19 publications

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“…27 Other international studies have shown an increase in Z-drug use over time while benzodiazepine use decreased, especially among people over 65 years of age. [28][29][30][31] In Canada, prescribing of benzodiazepines and Z-drugs in British Columbia decreased slightly from 1996 to 2006 in older people, but increased in younger segments of the population (females and people with low income). 20 To set our results in the context of other reports and to assess use of these drugs in the oldest and youngest groups, we stratified our population into 3 age groups.…”

Section: Discussionmentioning

confidence: 99%

Use of benzodiazepines and related drugs in Manitoba: a population-based study

et al. 2014

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Background: Despite their favourable toxicology profile, benzodiazepines and the related Z-drugs (zopiclone, zolpidem and zaleplon) have been associated with physiological tolerance, dependence and addiction. Evidence of harm (e.g., falls, motor vehicle collisions and cognitive disturbances) has been reported in older populations. The aim of this study was to determine the relation between users' characteristics and the use of benzodiazepines and Z-drugs in Manitoba over a 16-year period. Methods:This time-series analysis was based on prescription data from Apr. 1, 1996, to Mar. 31, 2012, obtained from the Drug Product Information Network database of Manitoba. We obtained sociodemographic information on benzodiazepine and Z-drug users from the Population Registry and determined changes in utilization rates over time using generalized estimating equations.Results: Overall, the prevalence of benzodiazepine use remained stable at about 61.0 per 1000 population between 1996/97 and 2011/12; however, the prevalence of Z-drug use increased steadily from 10.9 to 37.0 per 1000 over the same period. In older people (≥ 65 yr), the incidence of benzodiazepine use decreased from 55.5 to 30.3 users per 1000, whereas the incidence of Z-drug use increased from 7.3 to 20.3 users per 1000 over the study period. Among those 18-64 years of age, the incidence of benzodiazepine use decreased from 30.1 to 27.6 users per 1000, but the increase in incidence of Z-drug use was more than 2-fold. The youngest population (≤ 17 yr) showed the lowest rates of use of these drugs. The highest rates of use were observed among older women and the low-income population.Interpretation: Over the study period, benzodiazepines have been prescribed less frequently to older patients in Manitoba; however, zopiclone prescribing has continued to increase for all age groups. The reasons for this increase remain to be determined. AbstractCMAJ OPEN, 2(4) E209 Research CMAJ OPEN Methods Study populationAll Manitoba residents registered with the provincial health care system who were prescribed a benzodiazepine or a Z-drug between 1996/97 and 2011/12 were included. No age restrictions were applied, but patients were stratified by sex and age (0-17, 18-64 and ≥ 65 yr). Location of residence (urban v. rural) and socioeconomic status were also assessed. According to validated definitions, 23 incident (new) users were defined as people who had not received a prescription for any of the medications of interest in the year before receiving their first prescription, while prevalent users for each fiscal year were defined as people who had received at least 1 pres cription for a medication of interest that year.

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Section: Discussionmentioning

confidence: 99%

Use of benzodiazepines and related drugs in Manitoba: a population-based study

et al. 2014

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“…One study reported about 50% of all prescribed hypnotics to be zopiclone (Kassam et al, 2006), and another study reported that zolpidem accounted for 11% of all sleep promoting drugs prescribed and zopiclone for 9% (Ohayon et al, 1999). Use of z-hypnotics increases considerably with age and concomitant somatic or psychiatric disease (Hausken et al, 2009;Kassam et al, 2006;Ohayon et al, 1999). Because of the short terminal half-lives (compared to benzodiazepines), few negative effects on daytime vehicle driving would be expected from the use of z-hypnotics.…”

Section: Introductionmentioning

confidence: 93%

Impairment related to blood drug concentrations of zopiclone and zolpidem compared to alcohol in apprehended drivers

Gustavsen

Al-Sammurraie

Mørland

et al. 2009

Accident Analysis & Prevention

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“…The chance of a child receiving hypnotics was even bigger when the mother had used benzodiazepine hypnotics. Using benzodiazepine instead of z-hypnotics is related to psychiatric comorbidity 28. In cross-sectional studies an association between children's measured sleep problems and maternal mental health has been found 29–31.…”

Section: Discussionmentioning

confidence: 99%