How Much Benzodiazepine Prescribing is the Right Amount of Prescribing?-View Presentation Slides

View Presentation Slides

Pdf Summary

The document discusses benzodiazepine (BZD) prescribing, highlighting its risks and benefits, particularly for different demographic groups. It outlines the epidemiology of BZD use, revealing that older adults exhibit the highest usage rates, with growing use among middle-aged individuals. The discussion includes racial and ethnic differences in BZD use. <br /><br />The document challenges common misconceptions about BZDs, identifying increased risks associated with their use, including falls among older adults, motor vehicle accidents, overdose deaths, impaired cognition, and possible dementia connections. There's critical analysis on the utility and risks of BZDs in treating anxiety disorders, insomnia, schizophrenia, dementia, and depression. Notably, evidence supporting BZDs' clinical effectiveness is reportedly weak, fostering the need for cautious prescription practices.<br /><br />For stress and anxiety disorders, guidelines generally advise against using BZDs due to limited efficacy and high risks, suggesting alternatives like antidepressants or psychotherapy where possible. In cases of insomnia, recommendations emphasize the superiority of cognitive-behavioral therapy over pharmacotherapy. For psychiatric conditions like schizophrenia and bipolar disorder, concomitant BZD use correlates with worse health outcomes.<br /><br />Tapering strategies for discontinuing BZD use highlight the need for a gradual approach, emphasizing patient cooperation and avoiding abrupt cessation to reduce withdrawal symptoms. Supportive therapies, such as cognitive-behavioral therapy and some medications, may aid the tapering process, although evidence supporting adjunctive pharmacotherapies is limited.<br /><br />The document provides detailed methodologies for BZD tapering, including examples and expert advice, while urging prescribers to be vigilant and patient-centered. The ultimate goal is enhancing patient autonomy and safety while minimizing withdrawal distress, recognizing that some patients may still require ongoing low-dose BZD therapy.<br /><br />The summary encourages awareness of the complex balance between therapeutic benefits and potential harm in BZD prescribing, promoting safer, evidence-guided clinical decisions.

Keywords

benzodiazepine prescribing

risks and benefits

older adults

racial differences

anxiety disorders

insomnia treatment

tapering strategies

cognitive-behavioral therapy

withdrawal symptoms

evidence-guided decisions