Study, Apr/19:Benzo dependence in patients w/depression in outpatient psych unit

The full title of this Tunisian study is "Correlates of benzodiazepine dependence in patients with depression followed up in a psychiatric outpatient unit in Tunisia".

 

https://www.ncbi.nlm.nih.gov/pubmed/30983538

 

Abstract

 

Benzodiazepines may be prescribed to manage anxiety and insomnia in patients with depression. However, as noticed during our daily practice, a considerable proportion of patients treated for depression and receiving benzodiazepines developed a dependence to these medicines. Our aims were to estimate the proportion of patients with depression who develop a benzodiazepine dependence and to identify its correlates. We conducted a comparative study in Razi Hospital's outpatient psychiatry unit (Tunisia). We included patients aged 18 to 65 years who were diagnosed with depression during the first three quarters of 2014. Included patients were prescribed benzodiazepines. Follow-up period was of 2 years. A multivariate analysis was performed to identify dependence-associated factors. We included 54 patients, and 52% developed a benzodiazepine dependence during the follow-up period. Two associated factors were identified: a daily mean benzodiazepine dose of more than 9.5 milligrams of diazepam equivalents prior to taper off (p = .001) and a benzodiazepine taper-off initiated after the fifth week of benzodiazepine intake onset (p = .007). The proportion of patients who developed a benzodiazepine dependence was high. Low doses and time-limited benzodiazepine prescription should be taken into consideration when managing patients with depression in order to prevent dependence.

One huge problem with this study is that the sample is from only one hospital outpatient department.

Here is what I take from this study - people with depression who are seeking relief from anxiety and insomnia are being given Benzos.  These people (over 50%) become dependent on Benzos.  The kicker is that Benzos CAUSE depression and the hit to the teeth: these people have WORSE anxiety and insomnia after a long period on Benzos (tolerance) or when trying to withdraw.  Full circle.  My opinion is that Benzos should be used to keep someone from having a seizure and that is it.  When the risk is over, the Benzo should be discontinued.  All of uses of Benzos (sedation for a medical procedure, calming someone with crushing grief and the treatment of social/chronic anxiety) - should cease immediately.  This would make me very happy as Benzo dependence is literally causing deaths world wide.... so many health issues develop from using them that I am convinced that far too many deaths are a result of these drugs than are reported.  I am on a mission to get people off Benzos with as little suffering as possible but not taking years to taper.  I learned the very hard way to not C/T and I am concerned that there are many people with depression of using Benzos.

What surprised me about this study is that the rate of physical dependence caused by benzos wasn't higher than 50%. It's actually part of the action of the medication. It changes how things work in your brain, depending on how long you're on them.

 

Also, the fact that they didn't know about the risks of putting people on benzos for depression surprised me. How could they not know? Did they not read any of the medical literature before prescribing them?

 

Seriously disturbing.