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Study: Benzodiazepines Frequently Prescribed in Older COPD Patients Despite Harmful Side Effects

Drug class affects breathing ability and oxygen levels (Feb. 6)

Benzodiazepines are used in patients with chronic obstructive pulmonary disease (COPD) to treat symptoms of insomnia, depression, anxiety, and shortness of breath. Previous studies have linked these drugs with adverse outcomes, but until now there has been little information on how often they are prescribed or who is using them.

Joint treatment guidelines from the American Thoracic Society and the European Respiratory Society recommend that benzodiazepines be avoided in COPD patients because of potential respiratory side effects.

A new study published in Drugs and Aging looked at the scope of benzodiazepine use in older adults with COPD.

“I see a large number of COPD patients taking this medication class to help relieve disease-related symptoms, like insomnia, depression, and anxiety,” said lead author Dr. Nicholas Vozoris. “But considering the potential respiratory side effects and the well-documented neurocognitive side effects, like memory loss, decreased alertness, falls, and increased risk of motor vehicle accidents, the high frequency of benzodiazepine use in COPD is very concerning.”

Vozoris and his colleagues reviewed data from more than 100,000 COPD patients aged 66 years and older in Ontario, Canada, between 2004 and 2009 to determine how many new benzodiazepine drugs were dispensed and the severity of each patient’s COPD during treatment.

The researchers found that the dispensing of new benzodiazepines was common, occurring in more than one third of the patients. The use of benzodiazepines was 40% more likely among patients with more severe COPD. These patients also had the highest number of repeat prescriptions and early refills. In addition, benzodiazepines were commonly dispensed to older COPD patients while they were having disease flares.

“These findings are concerning because they tell us that the patients most at risk to be affected by the adverse effects of this drug are the same ones that are using it with the most frequency,” Vozoris said. “This medication could be causing harm in this already respiratory-vulnerable population.”

Although benzodiazepines can be effective for helping patients sleep, this drug class has been found to affect breathing ability and oxygen levels at night.

Source: St. Michael’s Hospital; February 6, 2013.

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