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The association between benzodiazepine and non-benzodiazepine and suicide: a nationwide cohort study

Published online by Cambridge University Press:  01 September 2022

N. Høier ,
T. Madsen ,
A. Spira ,
K. Hawton ,
P. Jennum ,
M. Nordentoft  and
A. Erlangsen
N. Høier*
Affiliation:
Mental Health Centre Copenhagen (CORE), Danish Research Institute For Suicide Prevention, Hellerup, Denmark
T. Madsen
Affiliation:
Mental Health Center Copenhagen, Core-copenhagen Research Center For Mental Health, Hellerup, Denmark
A. Spira
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Department Of Mental Health, Baltimore, United States of America
K. Hawton
Affiliation:
University of Oxford, Centre For Suicide Research, Oxford, United Kingdom
P. Jennum
Affiliation:
Danish Center for Sleep Medicine, Rigshospitalet, Copenhagen University, Copenhagen N, Denmark
M. Nordentoft
Affiliation:
CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
A. Erlangsen
Affiliation:
CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
*
*Corresponding author.

Abstract

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Introduction

Benzodiazepines and non-benzodiazepines have been linked to a variety of adverse effects including addiction. Long term use of these drugs has been associated with an increased risk of suicide.

Objectives

We assessed if individuals in treatment with non-benzodiazepine (n-BZD) and benzodiazepine (BZD) had higher rates of suicide when compared to individuals not in treatment with these drugs.

Methods

We utilized a cohort design and national longitudinal data on all individuals aged 10 or above who lived in Denmark between 1995 and 2018. Treatment with either n-BZD or BZD was identified via the Danish National Prescription Registry and suicide deaths were identified in the national cause of death registries.

Results

In a total of 6,494,206 individuals, 10,862 males and 4,214 females died by suicide. Of these, 1,220 (11.2%) males and 792 (18.8%) females had been in treatment with n-BZD, resulting in adjusted IRR for suicide of 4.2 (95% CI, 4.0 – 4.5) and 3.4 (95% CI, 3.1 – 3.7) for males and females, respectively, when compared to those not in treatment. In all, 529 (4.8%) males and 395 (9.3%) females who died by suicide had been in treatment with BZD. The IRRs for suicide were 2.4 (95% CI, 2.2 – 2.6) and 2.5 (95% CI, 2.3 – 2.8) for males and females, respectively, and compared to those not in treatment.

Conclusions

In this study we find that those in treatment experienced higher suicide rates than those not in treatment, this persisted when also adjusting for a large variety of covariates.

Disclosure

No significant relationships.

Keywords

Suicidesleep medicinePharmacologybenzodiazepine
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S181
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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