Despite the known risks for older people, prescription use of benzodiazepines — sedative and anti-anxiety medications such as alprazolam (Xanax) and diazepam (Valium) — increases with age, according to a new analysis of benzodiazepine prescription use in the United States.
The study is published in the journal JAMA Psychiatry.
The findings raise questions about why so many prescriptions — many for long-term use — are being written for this age group when such strong warnings exist concerning benzodiazepine use in older adults
Among all adults aged 18 to 80, about one in 20 received a benzodiazepine prescription in 2008, the period covered by the study. But this number steadily increased with age, from 2.6 percent among those aged 18 to 35, to 8.7 percent in those aged 65 to 80 (the oldest group studied).
Prescriptions for long-term use — more than 120 days — also increased with age. Of people 65 to 80 who used benzodiazepines, 31.4 percent received prescriptions for long-term use, compared to 14.7 percent of users 18 to 35.
In all age groups, women were about twice as likely as men to take benzodiazepines. Among women 65 to 80 years old, one in 10 received a prescription, with almost a third of these being long-term.
“These new data reveal worrisome patterns in the prescribing of benzodiazepines for older adults, and women in particular,” said Thomas Insel, M.D., director of the National Institute of Mental Health (NIMH), which supported the study.
“This analysis suggests that prescriptions for benzodiazepines in older Americans exceed what research suggests is appropriate and safe.”
Benzodiazepines are most often prescribed to treat anxiety and sleep problems. Although they are effective for both conditions, they come with risks, especially when used over long periods of time.
Long-term use can lead to dependence and withdrawal symptoms when discontinued. Research has also shown that benzodiazepines can impair cognition, mobility and driving skills, and increase the risk of falls in older people
“These medications can pose real risks, and there are often safer alternatives available,” said senior author Michael Schoenbaum, Ph.D. “Our findings strongly suggest that we need strategies to reduce benzodiazepine use, particularly for older women.”
Most prescriptions for benzodiazepines are written by non-psychiatrists. For adults 18 to 80 years old, about two-thirds of prescriptions for long-term use are written by non-psychiatrists; for those aged 65 to 80, it is nine out of 10.
Furthermore, a recently reported study shows a link between benzodiazepine use in older people and increased risk of Alzheimer’s disease. The connection was stronger with increasing length of use — nearly doubling for those using benzodiazepines for more than 180 days.