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Benzodiazepine Use (benzodiazepine + use)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Benzodiazepine use amongst community dwelling elderly: 10 years on

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2010
Aine Ní Mhaoláin
No abstract is available for this article. [source]

Benzodiazepine use in the elderly: an indicator for inappropriately treated geriatric depression?

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2009
Eva Assem-Hilger
Abstract Objective To measure the prevalence of benzodiazepine (BZD) use and to explore associated demographic and clinical variables of BZD use within a cohort of 75-year- old inhabitants of an urban district of Vienna. Methods This is a prospective, interdisciplinary cohort study on aging. Our investigation is based on the first consecutive 500 subjects that completed the study protocol. Demographic and clinical characteristics, benzodiazepine and antidepressant use were documented using a standardized questionnaire. Affective status was assessed using the Hamilton Depression Rating Scale (HAMD), the Geriatric Depression Scale (GDS), and the Spielberger State-and Trait Anxiety Inventory subscales (STAI). Results Prevalence of BZD use was 13.8%. Compared to non-users, BZD users had significantly higher mean scores at the HAMD (p,=,0.001), the GDS (p,=,0.026), and the Spielberger State-and Trait Anxiety Inventory subscales (p,=,0.003; p,=,0.001). Depression was found in 12.0% (HAMD) and 17.8% when using a self-rating instrument (GDS). Less than one-third of depressed subjects were receiving antidepressants. Statistically equal numbers were using benzodiazepines. Conclusions Inappropriate prescription of BZD is frequent in old age, probably indicating untreated depression in many cases. The implications of maltreated geriatric depression and the risks associated with benzodiazepine use highlight the medical and socioeconomic consequences of inappropriate BZD prescription. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Longitudinal patterns of new Benzodiazepine use in the elderly,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 10 2004
Gillian Bartlett PhD
Abstract Purpose To characterize longitudinal patterns of Benzodiazepine use in the elderly. Methods Prospective cohort of 78,367 community-dwelling Quebec residents aged 66 years or more who were new Benzodiazepine users, was followed for 5 years, 1989,1994. Data acquired from four population-based, provincial administrative databases were used to create time-dependent measures of change in dosage, switching or adding Benzodiazepines for 11 drugs listed in the provincial formulary. Subject-specific Spearman's rank correlation coefficients between dose and time were used to measure the tendency of increasing dose with consecutive periods of use. Multiple logistic regression and generalized estimating equations (GEE) models evaluated subject characteristics associated with increasing dose. Results The mean duration of uninterrupted Benzodiazepine use was 75.5 days. The mean daily dose was about half the recommended adult daily dose but 8.6% of subjects exceeded the recommended adult dose. Some of them (28.8%) switched medications at least once and 8.2% filled two or more prescriptions concurrently. For women, older age at date of first prescription was associated with increasing dose over time (odds ratio (OR) for 10 year age increase,=,1.23, p,<,0.001). Conclusion Long periods of Benzodiazepine use are frequent among Quebec elderly. The evidence of increasing dose, particularly for older women, and long-duration of use has important implications for clinicians. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Contribution of neuroinflammation in burning mouth syndrome: indications from benzodiazepine use

DERMATOLOGIC THERAPY, Issue 2008
Fabrizio Guarneri
ABSTRACT: Characterized by burning and painful oral sensations in absence of clinically significant mucosal abnormalities, the burning mouth syndrome is, despite numerous researches made, basically idiopathic and, consequently, difficult to treat effectively. Therapy with tricyclic antidepressants and benzodiazepines has been proposed, although the exact pathomechanism is not clear. The objective of this study is to define the possible reasons for the efficacy of benzodiazepines in the treatment of the burning mouth syndrome. Starting from the report of eight cases successfully treated with prazepam, the present authors examined the clinical features and the evidence from literature that support the possibility of a role of neuroinflammation in the pathogenesis of the burning mouth syndrome. Available data suggest that the nervous system could be crucial in the pathogenesis of the syndrome (altered perception of pain, disturbance of neural transmission, increased excitability, negative involvement of trigeminal-vascular system), and the present authors' experience lets them suppose a role for neuroinflammation. This hypothesis could also explain the positive response to benzodiazepines in some patients. The important role of neuroinflammation in dermatologic and oral diseases has been only recently investigated and acknowledged. Further studies on the connection between neuroinflammation and burning mouth syndrome could open interesting perspectives in the understanding and management of this difficult clinical condition. [source]

Maintenance therapy and 3-year outcome of opioid-dependent prisoners: a prospective study in France (2003,06)

ADDICTION, Issue 7 2009
Jean-Noël Marzo
ABSTRACT Aims To describe the profile of imprisoned opioid-dependent patients, prescriptions of maintenance therapy at imprisonment and 3-year outcome in terms of re-incarceration and mortality. Design Prospective, observational study (France, 2003,06). Setting Health units of 47 remand prisons. Participants A total of 507 opioid-dependent patients included within the first week of imprisonment between June 2003 and September 2004, inclusive. Measurements Physicians collected socio-demographic data, penal history, history of addiction, maintenance therapy and psychoactive agent use, general health status and comorbidities. Prescriptions at imprisonment were recorded by the prison pharmacist. Re-incarceration data were retrieved from the National Register of Inmates, survival data and causes of death from the National Registers of vital status and death causes. Findings Prison maintenance therapy was delivered at imprisonment to 394/507 (77.7%) patients. These patients had poorer health status, heavier opioid use and prison history and were less socially integrated than the remaining 113 patients. Over 3 years, 238/478 patients were re-incarcerated [51.3 re-incarcerations per 100 patient-years, 95% confidence interval (CI) 46.4,56.2]. Factors associated independently with re-incarceration were prior imprisonment and benzodiazepine use. After adjustment for confounders, maintenance therapy was not associated with a reduced rate of re-incarceration (adjusted relative risk 1.28, 95% CI 0.89,1.85). The all-cause mortality rate was eight per 1000 patient-years (n = 10, 95% CI 4,13). Conclusions Prescription of maintenance therapy has increased sharply in French prisons since its introduction in the mid-1990s. However, the risk of re-imprisonment or death remains high among opioid-dependent prisoners. Substantial efforts are needed to implement more effective preventive policies. [source]

Long-term effectiveness of computer-generated tailored patient education on benzodiazepines: a randomized controlled trial

ADDICTION, Issue 4 2008
Geeske Brecht Ten Wolde
ABSTRACT Aims Chronic benzodiazepine use is highly prevalent and is associated with a variety of negative health consequences. The present study examined the long-term effectiveness of a tailored patient education intervention on benzodiazepine use. Design A randomized controlled trial was conducted comprising three arms, comparing (i) a single tailored intervention; (ii) a multiple tailored intervention and (iii) a general practitioner letter. The post-test took place after 12 months. Participants Five hundred and eight patients using benzodiazepines were recruited by their general practitioners and assigned randomly to one of the three groups. Intervention Two tailored interventions, the single tailored intervention (patients received one tailored letter) and the multiple tailored intervention (patients received three sequential tailored letters at intervals of 1 month), were compared to a short general practitioner letter that modelled usual care. The tailored interventions not only provided different and more information than the general practitioner letter; they were also personalized and adapted to individual baseline characteristics. The information in both tailored interventions was the same, but in the multiple tailored intervention the information was provided to the participants spread over three occasions. In the multiple tailored intervention, the second and the third tailored letters were based on short and standardized telephone interviews. Measurements Benzodiazepine cessation at post-test was the outcome measure. Findings The results showed that participants receiving the tailored interventions were twice as likely to have quit benzodiazepine use compared to the general practitioner letter. Particularly among participants with the intention to discontinue usage at baseline, both tailored interventions led to high percentages of those who actually discontinued usage (single tailored intervention 51.7%; multiple tailored intervention 35.6%; general practitioner letter 14.5%). Conclusions It was concluded that tailored patient education can be an effective tool for reducing benzodiazepine use, and can be implemented easily. [source]

Effects of a sustained heroin shortage in three Australian States

ADDICTION, Issue 7 2005
Louisa Degenhardt
ABSTRACT Background In early 2001 in Australia there was a sudden and dramatic decrease in heroin availability that occurred throughout the country that was evidenced by marked increases in heroin price and decreases in its purity. Aim This study examines the impact of this change in heroin supply on the following indicators of heroin use: fatal and non-fatal drug overdoses; treatment seeking for heroin dependence; injecting drug use; drug-specific offences; and general property offences. The study was conducted using data from three Australian States [New South Wales (NSW), Victoria (VIC) and South Australia (SA)]. Methods Data were obtained on fatal and non-fatal overdoses from hospital emergency departments (EDs), ambulance services and coronial systems; treatment entries for heroin dependence compiled by State health departments; numbers of needles and syringes distributed to drug users; and data on arrests for heroin-related incidents and property-related crime incidents compiled by State Police Services. Time-series analyses were conducted where possible to examine changes before and after the onset of the heroin shortage. These were supplemented with information drawn from studies involving interviews with injecting drug users. Results After the reduction in heroin supply, fatal and non-fatal heroin overdoses decreased by between 40% and 85%. Despite some evidence of increased cocaine, methamphetamine and benzodiazepine use and reports of increases in harms related to their use, there were no increases recorded in the number of either non-fatal overdoses or deaths related to these drugs. There was a sustained decline in injecting drug use in NSW and VIC, as indicated by a substantial drop in the number of needles and syringes distributed (to 1999 levels in Victoria). There was a short-lived increase in property crime in NSW followed by a sustained reduction in such offences. SA and VIC did not show any marked change in the categories of property crime examined in the study. Conclusions Substantial reductions in heroin availability have not occurred often, but in this Australian case a reduction had an aggregate positive impact in that it was associated with: reduced fatal and non-fatal heroin overdoses; reduced the apparent extent of injecting drug use in VIC and NSW; and may have contributed to reduced crime in NSW. All these changes provide substantial benefits to the community and some to heroin users. Documented shifts to other forms of drug use did not appear sufficient to produce increases in deaths, non-fatal overdoses or treatment seeking related to those drugs. [source]

Benzodiazepines prescription in Dakar: a study about prescribing habits and knowledge in general practitioners, neurologists and psychiatrists

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2006
Amadou Moctar Dièye
Abstract Benzodiazepines are relatively well-tolerated medicines but can induce serious problems of addiction and that is why their use is regulated. However, in developing countries like Senegal, these products are used without clear indications on their prescription, their dispensation or their use. This work focuses on the prescription of these medicines with a view to make recommendations for their rational use. Benzodiazepine prescription was studied with psychiatrists or neurologists and generalists in 2003. Specialist doctors work in two Dakar university hospitals and generalists in the 11 health centres in Dakar. We did a survey by direct interview with 29 of 35 specialists and 23 of 25 generalists. All doctors were interviewed in their office. The questionnaire focused on benzodiazepine indications, their pharmacological properties, benzodiazepines prescribed in first intention against a given disease and the level of training in benzodiazepines by doctors. Comparisons between specialists and generalists were made by chi-square test. Benzodiazepines were essentially used for anxiety, insomnia and epilepsy. With these diseases, the most benzodiazepines prescribed are prazepam against anxiety and insomnia and diazepam against epilepsy. About 10% of doctors do not know that there is a limitation for the period of benzodiazepine use. The principal reasons of drugs choice are knowledge of the drugs, habit and low side effects of drugs. All generalists (100%) said that their training on benzodiazepines is poor vs. 62.1% of specialists, and doctors suggest seminars, journals adhesions and conferences to complete their training in this field. There are not many differences between specialists and generalists except the fact that specialists prefer prazepam in first intention in the insomnia treatment where generalists choose bromazepam. In addition, our survey showed that specialists' training in benzodiazepines is better than that of generalists. Overall, benzodiazepine prescription poses problems particularly in training, and national authorities must take urgent measures for rational use of these drugs. [source]

Benzodiazepine use in the elderly: an indicator for inappropriately treated geriatric depression?

The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent?

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2007
E. J. M. Bierman
Abstract Objective This study investigates the effects of benzodiazepine (BZ) use on cognitive performance in elderly persons in a longitudinal design. Study design and setting Data were obtained from the Longitudinal Aging Study Amsterdam (LASA), in the Netherlands. 2,105 respondents (,62 years of age) were included and had repeated measurements over a period of 9 years. For all BZs the type, dosage, frequency and duration of use was measured. The equivalent of a dose of diazepam was determined with regard to type and dosage and a cumulative dosage was calculated. General cognitive functioning was measured with the Mini-Mental State Examination, information processing speed was measured with the coding task, fluid intelligence with Raven's Coloured Progressive Matrices and episodic memory with the Auditory Verbal Learning Test. Multilevel analyses were used to investigate the relationship between BZ use and cognitive decline. Results A negative effect of BZ use on cognitive performance was found. However, the effect sizes were very small. Conclusion This study suggests that both duration and cumulative exposure to BZ has a small negative effect on the long-term cognitive functioning of elderly people in the community. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Use of night-time benzodiazepines in an elderly inpatient population

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2002
M. Ramesh MPharm PGDCP FICP
Aim:,To examine benzodiazepine prescribing for sleep induction in an elderly medical inpatient population to determine if hospital prescribing may have encouraged benzodiazepine use following discharge. Secondary objectives included assessment of quality of sleep in hospital compared with home and monitoring for possible benzodiazepine side-effects. Method:,Inpatient and discharge prescribing of benzodiazepines used for sleep induction were recorded in two medical wards over a 3-month period. A questionnaire was used to obtain information on patients' sleep patterns at home and in hospital. A follow-up telephone survey at 2,3 weeks post-discharge was made for those patients who were prescribed benzodiazepine at discharge. Results:,Benzodiazepines were prescribed for 20% of patients with 94% of prescriptions being for temazepam. Of the 54 patients prescribed benzodiazepines during admission, 57% were not taking a benzodiazepine at home prior to their hospital admission. At discharge, 14 patients were prescribed benzodiazepines for home use, eight of whom had not used them at home previously. On follow-up none of these eight patients expressed a desire to continue benzodiazepine use for sleep induction. There was a significant (P < 0·05) reduction in sleep onset latency and number of nocturnal awakenings in hospital when compared with home. There was no change in sleep duration and overall quality of sleep. There was an association between early morning insomnia and benzodiazepine use. Conclusion:,Discharge prescribing of benzodiazepines was appropriately limited to temazepam and did not encourage home use in previous non-users. Benzodiazepines (primarily temazepam) were effective in the short term for inducing sleep in the hospital setting, with little evidence of side-effects. [source]

Risk Factors for Delirium Tremens: A Retrospective Chart Review

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 3 2006
Tara Wright MD
A retrospective chart review was performed within an inpatient VA hospital setting in an attempt to identify risk factors for delirium tremens (DTs). Cases of delirium tremens were compared to cases where patients' alcohol withdrawal during hospitalization did not progress to DTs. Significant differences were found in regard to prior histories of DTs and laboratory values at admission. The amount and duration of benzodiazepine use during hospitalization, antipsychotic use during hospitalization, and length of hospitalization were also statistically different between the groups. While not reaching statistical significance, there were differences in reason for admission and relapse rate upon follow-up between the groups. [source]

The contribution of injecting drug users in Sydney, Melbourne and Brisbane to rising benzodiazepine use in Australia 2000 to 2006

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010
Alesha Smith
Abstract Objective: To determine whether the increased utilisation of benzodiazepines in Australia from 2000 to 2006 could be accounted for by the increased use of benzodiazepines among those who inject heroin Method: Areas known to have high numbers of injecting drug users, (IDU) in Sydney, Melbourne and Brisbane, Australia were identified. Data were obtained from the Medicare and the Drug Utilization Sub-Committee databases on all benzodiazepines dispensed to concession beneficiaries in the chosen areas and Australia as a whole. The utilisation of benzodiazepines was calculated in defined daily dose per 1000 (DDD/1000) beneficiaries and for IDU/day using the estimated numbers of IDU, from 2000-2006. Results: The utilisation of benzodiazepines increased by 22% for all Australian concession beneficiaries but in areas with a high proportion of IDU, the utilisation of benzodiazepines decreased. Conclusions: In areas known to have a high proportion of IDU, the concession beneficiary use of benzodiazepines was estimated to be largely accounted for IDU usage. However, the overall increase in benzodiazepine utilisation by Australian concession beneficiaries from 2000 to 2006 was not primarily driven by use among IDU who only accounted for a small proportion of total benzodiazepines use. Implications: It appears that sub-groups of the populations, other than IDU may be responsible for the increase in benzodiazepine use by concession beneficiaries. [source]

Impaired vision and other factors associated with driving cessation in the elderly: the Blue Mountains Eye Study

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2001
Jagjit Singh Gilhotra MBBS
ABSTRACT The aim of present study was to review vision and other factors associated with the cessation of driving. As part of the Blue Mountains Eye Study, detailed demographic information, driving status and medical history were taken. Visual acuity was measured during a standardized refraction and visual fields documented. Potential risk factors were decided a priori. Among the 3654 Eye Study participants, 2831 (77.5%) had driven a motor vehicle in the past, of whom 2379 (84.0%) were current drivers and 452 (16.0%, 95% CI 14.6,17.4%) said they had stopped driving. Older persons and women were more likely to have stopped driving. After adjusting for age and sex, sensory impairment affecting vision and hearing, plus chronic medical conditions and benzodiazepine use were significantly associated with cessation of driving. The study found that sensory impairment, particularly visual parameters, was associated with the decision to stop driving by older subjects. [source]