Use of benzodiazepines has shown to increase with age despite the known risks for older patients, according to an analysis of benzodiazepine prescribing in the United States. This study was funded by the National Institutes of Health (NIH).

Though current guidelines warn healthcare providers of benzodiazepine use among older adults, the study calls into question why increasing prescriptions, many for chronic use, are being prescribed for this age group.

The study showed that one in 20 adults (aged 18–80 years) received a benzodiazepine prescription in 2008. This proportion increased with age, from 2.6% among 18–35 year olds to 8.7% among 65–80 year olds. Chronic use, defined as a >120 day supply, also increased significantly with age.

Of those in the 65–80 year old group, 31.4% received prescriptions for long-term use vs. 14.7% of patients in the 18–35 year old group. Across all age groups studied, women were twice as likely to receive benzodiazepines than men; one in 10 women aged 65–80 years old were prescribed one of these medications, with almost one-third receiving long-term prescriptions.

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Other key findings showed that overall, about one in four of prescriptions involved long-acting formulations of benzodiazepines. Also, most benzodiazepine prescriptions were written by non-psychiatrists.

Common benzodiazepines include Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam). This class of drugs are widely used to treat anxiety and sleep disorders. Long-term use can lead to dependence and withdrawal symptoms upon discontinuation. In older patients, use of benzodiazepines can impair cognition, mobility, and driving skills, as well as increase the risk of falls. Guidelines recommend nonpharmacologic options and antidepressants over benzodiazepines as first-line treatment of anxiety. For sleeping disorders, guidelines recommend considering behavioral interventions as first-line treatment over medication.

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