Benzodiazepine withdrawal in older people: what is the prevalence, what are the signs, and which patients?

Eur J Clin Pharmacol. 2021 Feb;77(2):171-177. doi: 10.1007/s00228-020-03007-7. Epub 2020 Oct 2.

Abstract

Purpose: Benzodiazepines (BZDs) and related drugs (Z-drugs) are mainly taken chronically, and older people are much more likely to take them on a chronic basis despite recommendations. Withdrawal symptoms could be an obstacle to stopping BZD/Z-drug administration. The main objective of this study is to estimate the prevalence of withdrawal symptoms in patients aged 65 years and older who have experience a stop of BZD/Z-drug. The secondary objectives are to describe the withdrawal symptoms and identify factors associated.

Method: This ancillary study was based on a national observational study in patients with chronic BZD/Z-drug consumption. Patients who made at least one BZD/Z-drug stop experience were selected. Withdrawal symptoms are described, and a logistic regression was carried out to identify the variables most associated with withdrawal symptoms.

Results: In total, 697 patients were selected: 78% experienced at least one withdrawal symptom after a stop administering BZDs or Z-drugs; most of the withdrawal symptoms were psychological disorders.

Conclusion: Our study identifies a specific population experiencing withdrawal symptoms and who cannot stop administering BZD/Z-drug. We assume that withdrawal symptoms in patients with chronic use play an essential role in the nonstop use of BZD/Z-drugs.

Keywords: Benzodiazepine; Chronic use; Older people; Withdrawal symptoms; Z-drug.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Benzodiazepines / adverse effects*
  • Female
  • Humans
  • Hypnotics and Sedatives / adverse effects*
  • Male
  • Mental Disorders / chemically induced
  • Mental Disorders / epidemiology*
  • Nervous System Diseases / chemically induced
  • Nervous System Diseases / epidemiology*
  • Prevalence
  • Prospective Studies
  • Substance Withdrawal Syndrome*

Substances

  • Hypnotics and Sedatives
  • Benzodiazepines