Original Article
Symptoms Associated with Long-term Benzodiazepine Use in Elderly Individuals Aged 65 Years and Older: A Longitudinal Descriptive Study

https://doi.org/10.1016/j.ijge.2014.03.009Get rights and content
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Summary

Background

Recent epidemiologic studies have shown that the use of psychotropics is associated with many symptoms and may result in dependence and tolerance among elderly individuals. The aim of this study was to describe the symptoms related to withdrawal or dose reduction of long-term benzodiazepine (BZD) or BZD-related drugs (RDs) use and to compare them with nonuse of these drugs in community-dwelling individuals aged 65 and older.

Methods

The study was a post hoc analysis embedded in a 12-month randomized, controlled fall-prevention trial that included withdrawal of BZDs and RDs. The participants (n = 248) in the intervention group were divided into the following four groups according to their use of BZDs/RDs at baseline and follow-up: (1) withdrawal (WG), (2) reduction (RG), (3) unchanged (UG), and (4) nonusers (NUG). Differences in symptom changes were compared between and within these four groups.

Results

Using BZD/RD was associated with numerous symptoms at baseline and during the intervention. At follow-up, those symptoms reduced significantly among all participants. However, there were no significant differences between the groups in the changes of symptoms during the follow-up. Self-perceived health improved in only NUG (p < 0.001), but not in the other groups (WG, RG, and UG).

Conclusion

Withdrawal or reduction of BZD/RD produced positive effects on physical, psychological, or cognitive symptoms among all participants, but no differences between the groups were detected. We recommend that clinical goals should be carefully assessed against the risks of long-term BZD/RD use, and that withdrawal interventions should be initiated for community-dwelling users aged 65 and older, especially those long-term users who may already be experiencing adverse drug effects.

Keywords

aged
psychotropics
reduction
symptoms
withdrawal

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Conflicts of interest: All contributing authors declare that they have no conflicts of interest.