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Initial 3-month usage characteristics predict long-term use of benzodiazepines: an 8-year follow-up

  • Pharmacoepidemiology and Prescription
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Abstract

Objective

The aim of the study was to identify initial usage predictors for prolonged benzodiazepine use.

Methods

An 8-year pharmacy data-based study (1983–1992) was carried out on a retrospective cohort of 425 initial benzodiazepine users. The setting was the only pharmacy in a community of 13,500 people.

Results

Among the 425 initial users, 36% had a single initial exposure year, 50% had two to seven exposure years, and 14% had benzodiazepine use during all 8 years of follow-up. Prolonged use over more years was associated with an initial high number of prescriptions, elderly patients and initial use of hypnotics. Two patterns of irregular prolonged use were investigated: increase in use was associated with a shorter length of the first usage period and switching to another benodiazepine during the first 90 days; relapses of use were associated with a shorter length of first usage period and initial use of an anxiolytic. Gender and initial dosage were not associated with prolonged use at all.

Conclusion

During the first 90 days after initiation of benzodiazepine use, a number of determinants of prolonged benzodiazepine use were visible. The prescribers of these drugs and the pharmacists should advise rational use not only at the start but also at the moment of the first repeat prescription in order to prevent needless prolonged use and dependence.

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Author information

Authors and Affiliations

  1. Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, P.O. Box 80.082, 3508TB , Utrecht, The Netherlands

    Rolf van Hulten, K. Bart Teeuw, Albert Bakker & Hubert G. Leufkens

Authors
  1. Rolf van Hulten
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  2. K. Bart Teeuw
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  3. Albert Bakker
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  4. Hubert G. Leufkens
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Corresponding author

Correspondence to Rolf van Hulten.

Classification of benzodiazepines in study population

Classification of benzodiazepines in study population

  • Short t1/2: bromazepam, flunitrazepam, lorazepam, oxazepam, temazepam

  • Long t1/2: chlordiazepoxide, clobazam, clorazepic acid, diazepam, flurazepam, nitrazepam, nordazepam, prazepam

  • Fast tmax: bromazepam, chlordiazepoxide, clorazepic acid, diazepam, flunitrazepam, flurazepam, temazepam

  • Slow tmax: clobazam, lorazepam, nitrazepam, nordazepam, prazepam, oxazepam

  • 5-aryl halog: flunitrazepam, flurazepam, lorazepam

  • No 5-aryl halog: bromazepam, chlordiazepoxide, clobazam, clorazepic acid, diazepam, nitrazepam, nordazepam, oxazepam, prazepam, temazepam

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van Hulten, R., Teeuw, K.B., Bakker, A. et al. Initial 3-month usage characteristics predict long-term use of benzodiazepines: an 8-year follow-up. Eur J Clin Pharmacol 58, 689–694 (2003). https://doi.org/10.1007/s00228-002-0548-0

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  • DOI: https://doi.org/10.1007/s00228-002-0548-0

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