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Benzodiazepine Use Increases in Older Adults, Despite Risks

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January 14, 2015 — JAMA Psychiatry has published a study with concerning evidence that prescriptions for benzodiazepines increase among older adults, especially women, with no clear justification and despite well-known safety risks.

Benzodiazepines are a class of sedatives that include alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan).

Long-term use can lead to dependence and withdrawal symptoms if they are discontinued. Older adults are also more likely to develop problems with cognitive impairment, mobility, driving skills, and falls.

One study published in the British Medical Journal last year also linked benzodiazepines with a 50% increased risk of Alzheimer’s disease, with even higher risks associated with long-term use.

The researchers found several concerning findings:

  • 1 in 10 women between 65 and 80 years old were on a benzodiazepine, including nearly one-third on long-term prescription.
  • Overall, most prescriptions were written by non-psychiatrists — including 90% of prescriptions for older women.
  • Prescriptions increased with age, with 2.6% of 18-35 year-olds, 5.4% of 36-50 year-old, and 8.4% of 65-80 year-olds.

Benzodiazepines are prescribed for anxiety and insomnia, but experts do not know why prescriptions increase among older adults. Anxiety problems decrease with age and sedatives are not recommended as a first-line treatment for insomnia.

Dr. Thomas Insel, director of the National Institute of Mental Health, warned:

“These new data reveal worrisome patterns in the prescribing of benzodiazepines for older adults, and women in particular. This analysis suggests that prescriptions for benzodiazepines in older Americans exceed what research suggests is appropriate and safe.”

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