Long-Term Benzodiazepine Use and Mortality: Are we Doing the Right Studies?
Umesh Kalum Amarasuriya, Puja R. Myles and Robert David Sanders
Affiliation: Wellcome Department of Imaging Neuroscience, Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, UK.
Benzodiazepines are World Health Organisation essential medicines used in the treatment of alcohol
withdrawal, anaesthesia, sedation, anxiolysis, behavioural disturbance, epilepsy, insomnia, palliative care, and muscle
spasm. Despite their widespread use concerns remain over their long-term safety through both neuronal and non-neuronal
effects. We conducted a systematic review to identify vulnerable populations of patients who may be at increased risk of
harm from benzodiazepines. We identified three potentially “at risk” groups of patients, those with renal disease, lung
disease and those recently hospitalised. However methodological limitations including selection bias, vague descriptors of
benzodiazepine use and inappropriate grouping together of benzodiazepines with other medications, precluded definitive
conclusions. Future studies should concentrate on these groups to identify the long-term safety of benzodiazepines in
these patient groups.
Keywords: Benzodiazepine, mortality, infection, renal failure, dialysis, pneumonia, delirium, anxiolysis, anxiolysis, behavioural disturbance, epilepsy, insomnia, palliative care, muscle spasm, prognosis, anaesthesia, sedation
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