May/20: "Systematic review of benzodiazepines for anxiety disorders in late life

"Systematic review of benzodiazepines for anxiety disorders in late life"

https://www.ncbi.nlm.nih.gov/pubmed/32343283

Abstract

BACKGROUND:

Benzodiazepines are currently the most commonly prescribed medication for the treatment of anxiety in older adults, although there is a dearth of good-quality data on this subject. The aim of this review was to systematically review studies examining the efficacy and tolerability of benzodiazepines for the treatment of anxiety disorders among older adults.

METHODS:

The authors conducted a systematic review, searching PubMed, Ovid MEDLINE, Ovid Embase, Web of Science, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials. All searches were limited to English-language articles. The quality of each study was appraised using criteria developed by the Centre for Evidence-Based Medicine for randomized controlled trials.

RESULTS:

A total of 8,785 citations were retrieved and pooled in EndNote and de-duplicated to 3,753. This set was uploaded to Covidence for screening. Two separate screeners (AG and SAF) evaluated the titles, abstracts, and full text of the eligible articles. Five studies met the inclusion criteria. Across all studies, benzodiazepines were associated with decreased anxiety at the end of the study period. The limited tolerability data show mild adverse effects from the benzodiazepines studied. Limitations of the trials included limited data on the long-term use of benzodiazepines for anxiety and a preponderance of trials examining generalized anxiety disorder, with relatively less data on other anxiety disorders.

CONCLUSIONS:

Benzodiazepines are effective for treating anxiety disorders in late life, at least in the short term, but more data is needed to establish tolerability and their long-term benefits.

Benzodiazepines are effective for treating anxiety disorders in late life, at least in the short term, but more data is needed to establish tolerability and their long-term benefits.

These benzos have been prescribed to people FOR 60 YEARS NOW. I'm assuming that no one is willing to do a study on long-term benzo prescriptions because there is no money in it and to find out the truth would be too alarming for patients. They keep saying "more data is needed," but they've become empty words.

I would like to find out what it is in my makeup that causes such terrible symptoms at 6 years off. Although there are some symptoms that are improving, there are others that have ramped up (bp, for instance). It's absolutely scary.

It seems that finding out the truth would be a gut-punch to all concerned, but the truth has to be faced sometime. The real question is when, and what medication will take the benzos' place? Or perhaps the better solution would be ramping up natural therapies and supplements and even offering cannabis to those who can handle it. It's much too easy to leave heads in the sand and let sleeping dogs lie. 

I know, Terry. This one is really short-sighted, but yes, of course, benzos give people relief in the short-term. Most studies conclude with "more data is needed", but I think you and I and most BBs are well aware of the dangers of long-term use. We're all living proof.

Did you see the other paper I posted? The one about the need for "systematic change" with regards to benzos? Have a look:

http://www.benzobuddies.org/forum/index.php?topic=240511.0 

Here's an excerpt:

Benzodiazepines are associated with serious side effects and risks including, but not limited to,cognitive impairment, falls, motor vehicle accidents, abuse, dependence [2] and all-cause mortality[3].  Older adults are more vulnerable to these risks [2].  Some data suggest long-term use may be associated with Alzheimer’s disease, while others argue this conclusion is premature [4].  On top of the risks, there is no evidence of long-term efficacy.Nevertheless, long-term use is common, has increased, accounts for 30-40% of prescribingand is more common in older adults [5]. There is evidence that only a third of prescriptions in older adults areappropriate [2]