COMMENTARY

Do Benzodiazepines Increase All-Cause Mortality?

Peter M. Yellowlees, MBBS, MD

Disclosures

November 07, 2017

This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

A number of recent studies have suggested that the benzodiazepines are more dangerous than originally thought, especially in the elderly. Now a team of investigators[1] from Harvard Medical School, Boston, have undertaken a retrospective cohort study to evaluate the risk of all-cause mortality associated with initiating, compared with not initiating, benzodiazepines in adults. A large de-identified US commercial healthcare database (Optum Clinformatics Data Mart; N = 1,252,988) was used, and all-cause mortality was determined by linkage with the Social Security Administration Death Master File. Over a 6-month follow-up period, 5061 and 4691 deaths occurred among high-dimensional propensity score-matched benzodiazepine initiators versus noninitiators. The researchers concluded that this study suggests that there is either no increase or at most a minor increase in risk for all-cause mortality associated with benzodiazepine initiation. They determined that if a detrimental effect exists, it is likely to be much smaller than previously stated and to have uncertain clinical relevance.

This is a reassuring study that should calm much of the recent anxiety among clinicians related to benzodiazepine prescribing. While it is important to continue to use vigilance when prescribing these agents, and certainly to be aware of long-term adverse consequences like addiction, delirium, and pseudodementia, it is good to know that they are less likely to be potentially lethal than has been suggested in other, smaller studies.

Thank you for listening to this Medscape Psychiatry Minute. Do continue to enjoy your practice.

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