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Extent and appropriateness of benzodiazepine use

Results from an elderly urban community

Published online by Cambridge University Press:  02 January 2018

S. Taylor ,
C. F. M. McCracken ,
K. C M. Wilson  and
J. R. M. Copeland
S. Taylor*
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
C. F. M. McCracken
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
K. C M. Wilson
Affiliation:
EMI Academic Unit, St Catherines Hospital, Birkenhead
J. R. M. Copeland
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
*
S. Taylor, EMI Academic Unit. St Catherine's Hospital, Church Road, Birkenhead L42 0LQ. Tel: 0151 604 7333; Fax: 0151 653 3441
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Abstract

Background

We sought to determine the extent and appropriateness of benzodiazepine use in an elderly community, by measuring prevalence and incidence of benzodiazepines and examining mental health status as a predictor of benzodiazepine use.

Method

Data were collected from two longitudinal studies of people from the same community, sampled in 1982–1983 and again in 1989–1991.

Results

Benzodiazepine prevalence did not decrease during the period under study, but there was a significant reduction in anxiolytic use. Prevalence of benzodiazepines in women is twice that in men, and incidence of hypnotics is slightly higher in women. Prevalence and incidence of hypnotics are strongly associated with increasing age. There were high proportions of long-term users (61 and 70%), and continued use was high (52%) among new users. A large proportion of benzodiazepine use was by those who were concurrently depressed. Similarly, anxiety predicted both current and subsequent use of hypnotics.

Conclusions

Many older people still use benzodiazepines, contrary to official guidelines with regard to their mental health. Our findings add to the weight of opinion that persistent and long-term use should be discouraged.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 5 , November 1998 , pp. 433 - 438
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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Footnotes

†

See editorial pp. 361–362, this issue.

References

Ashton, H. (1991) Psychotropic-drug prescribing for women. British Journal of Psychiatry, 158 (suppl. 10). 30–35.CrossRefGoogle Scholar
Ashton, H. (1994) Guidelines for the rational use of benzodiazepines. Drugs, 48, 25–40.CrossRefGoogle ScholarPubMed
Balestrieri, M., Bortolomasi, M., Galletta, M., et al (1997) Patterns of hypnotic drug prescription in Italy. A two-week community survey. British Journal of Psychiatry, 170, 176–180.CrossRefGoogle ScholarPubMed
Beers, M. H., Ouslander, J. G., Rollingher, I., et al (1991) Explicit criteria for determining inappropriate medication use in nursing homes. Archives of Internal Medicine, 151, 1825–1832.Google Scholar
British Medical Association & Royal Pharmaceutical Society of Great Britain (1996) British National Formulary. London and Wallingford: BMA & RPS.Google Scholar
Copeland, J. R. M., Kelleher, M. J., Kellet, J. M., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State schedule. I. Development and reliability. Psychological Medicine, 6, 439–449.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) A computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Dewey, M. E. & Saunders, P. (1991) The epidemiology of dementia: GMS-AGECAT studies of prevalence and incidence, including studies in progress. European Archives of Psychiatry and Clinical Neuroscience, 240, 212–217.Google Scholar
Corlett, A. J. (1996) Aids to compliance with medication. British Medical Journal, 313, 926–929.CrossRefGoogle ScholarPubMed
Dunbar, G. C., Perera, M. H. & Jenner, F. A. (1989) Patterns of benzodiazepine use in Great Britain as measured by a general population survey. British Journal of Psychiatry, 155, 836–841.CrossRefGoogle ScholarPubMed
Eaton, W. W., Kramer, M., Anthony, J. C., et al (1989) Conceptual and methodological problems in the estimation of the incidence of mental disorders from field survey data. In Epidemiology and the Prevention of Mental Disorders (eds Cooper, B. & Helgason, T.), pp. 108–131. London: Routledge.Google Scholar
Genstat 5 (1994) Release 3 Reference Manual. Oxford: Numerical Algorithms Group.Google Scholar
Murray, J., Dunn, G., Williams, P., et al (1981) Factors affecting the consumption of psychotropic drugs. Psychological Medicine, 11, 551–560.CrossRefGoogle ScholarPubMed
Neutel, C. I., Hirdes, J. P., Maxwell, C. J., et al (1996) New evidence on benzodiazepine use and falls: the time factor. Age and Ageing, 25, 273–278.Google Scholar
Olfson, M. & Pincus, H. A. (1994) Use of benzodiazepines in the community. Archives of Internal Medicine, 154, 1235–1240.CrossRefGoogle ScholarPubMed
Paykel, E. S. & Priest, R. G. (1992) Recognition and management of depression in general practice: consensus statement. British Medical Journal, 305, 1198–1202.Google Scholar
Ranstam, J., Merlo, J., Blennow, G., et al (1997) Impaired cognitive function in elderly men exposed to benzodiazepines or other anxiolytics. European Journal of Public Health, !, 149–152.CrossRefGoogle Scholar
Saunders, P. A., Copeland, J. R. M., Dewey, M. E., et al (1993) The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC-ALPHA study. International Journal of Epidemiology, 22, 838–847.CrossRefGoogle ScholarPubMed
Shader, I. R. & Greenblat, D. J. (1993) Use of benzodiazepines in anxiety disorders. New England Journal of Medicine, 328, 1398–1405.Google ScholarPubMed
Siciliani, O., Bellantuono, C., Williams, P., et al (1985) Self-reported use of psychotropic drugs and alcohol abuse in South-Verona. Psychological Medicine, 15, 821–826.CrossRefGoogle ScholarPubMed
Sullivan, C. F., Copeland, J. R. M., Dewey, M. E., et al (1988) Benzodiazepine use amongst the elderly: findings of the Liverpool community survey. International Journal of Geriatric Psychiatry, 3, 289–292.Google Scholar
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