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. 2007 Sep 6;125(5):270-4.
doi: 10.1590/s1516-31802007000500004.

Chronic use of diazepam in primary healthcare centers: user profile and usage pattern

Carmen Sylvia Ribeiro  1 , Renata Cruz Soares Azevedo, Viviane Franco da Silva, Neury José Botega
Affiliations

Chronic use of diazepam in primary healthcare centers: user profile and usage pattern

Carmen Sylvia Ribeiro et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context and objective: Chronic use of benzodiazepines is frequent in general practice. The aim of this study was to describe the usage pattern and profile of chronic users of diazepam who had been consuming this drug for a minimum of thirty-six months continuously.

Design and setting: This was a descriptive study (survey and clinical assessment) at five primary healthcare centers in Campinas, Brazil.

Methods: Psychotropic drug control books revealed 48 eligible patients. Among these, 41 were assessed by means of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), the Hospital Anxiety and Depression scale (HAD) and a questionnaire on usage pattern.

Results: Most patients were women (85.4%). The patients' mean age was 57.6 years, and they were from the social strata C (39%), D (54%) and E (7%). The mean length of diazepam consumption was 10 years. The patients presented a lack of prescription compliance and had made frustrated attempts to stop using the drug. 55.5% said their doctor had never given any guidance on the effects of the drug. According to SCAN, 25 patients (61%) suffered from depressive disorders; only 12 cases of benzodiazepine dependence were detected by this instrument.

Conclusion: There is a need to improve the detection and treatment of mental disorders, as well as to prevent inappropriate prescription and use of benzodiazepines. Diazepam dependence has distinctive characteristics that make it undetected by SCAN.

CONTEXTO E OBJETIVO:: O uso crônico de benzodiazepínicos é freqüente. O objetivo deste estudo foi descrever o padrão de uso e o perfil dos usuários crônicos de diazepam (uso contínuo por no mínimo 36 meses) atendidos em unidades básicas de saúde.

TIPO DE ESTUDO E LOCAL:: Estudo descritivo, com inquérito e avaliação clínica padronizada, realizado em cinco unidades básicas de saúde de Campinas, São Paulo.

MÉTODO:: Os livros de controle de dispensa de psicofármacos revelaram 48 pacientes elegíveis, 41 dos quais foram avaliados por meio do Schedule for Clinical Assessment in Neuropsychiatry (SCAN), pela escala Hospital Anxiety and Depression (HAD) e de um questionário sobre padrão de uso.

RESULTADOS:: A maioria dos usuários era de mulheres (85,4%), com média de idade de 57,6 anos, pertencentes aos estratos socioeconômicos C (39%), D (54%) e E (7%). O tempo médio de uso de diazepam foi de 10 anos. Havia inobservância em relação à forma aconselhada de se utilizar o diazepam, bem como tentativas frustradas de parar a medicação. 55.5% afirmaram que não receberam orientações de seus médicos sobre os efeitos do medicamento. De acordo com o SCAN, 25 pacientes (61%) sofriam de depressão; apenas 12 casos de dependência a benzodiazepinas foram detectados por tal instrumento.

CONCLUSÃO:: São necessárias medidas que possam aprimorar a detecção e tratamento de transtornos mentais, assim como prevenir a prescrição e uso inadequado de benzodiazepinas. A dependência de bezodiazepínicos tem características que a difereciam de outras dependências químicas e não é detectada pelo SCAN.

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Conflict of interest statement

Conflicts of interest: None

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