COMMENTARY

More Bad News About Benzos

Arefa Cassoobhoy, MD, MPH

Disclosures

September 05, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

Benzodiazepines are in the news again—this time, not for the increased risk for falls and fractures that can come with their use.

A case-control study was conducted in Finland among community-dwelling adults who had been diagnosed with Alzheimer disease. Benzodiazepines and related Z drug use was associated with a modestly increased risk for Alzheimer disease. No real differences were seen for the drug subcategories. This included short-, medium-, and long-acting benzodiazepines, as well as zolpidem, zaleplon, and eszopiclone.

The analysis showed that 5.7% of dementia cases among adults using benzodiazepines were due to the drugs. Even this small increased risk could be significant because they are widely prescribed to elderly adults, often long term. The drugs are given to treat prodromal and neuropsychiatric symptoms of dementia like insomnia and anxiety.

The authors concluded that benzodiazepines and Z drugs should be avoided when possible, given their adverse-event profile. For patients who you would like to wean off benzodiazepines, deprescribing can be tough and take a long time. Guidelines are now available to help you with the process.

Follow Dr Cassoobhoy on Twitter at @ArefaMD

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