Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug;73(8):927-935.
doi: 10.1007/s00228-017-2257-8. Epub 2017 Apr 30.

A systematic review of interventions to deprescribe benzodiazepines and other hypnotics among older people

Emily Reeve  1   2 , Magdalene Ong  3 , Angela Wu  3 , Jesse Jansen  4   5 , Mirko Petrovic  6 , Danijela Gnjidic  3
Affiliations

A systematic review of interventions to deprescribe benzodiazepines and other hypnotics among older people

Emily Reeve et al. Eur J Clin Pharmacol. 2017 Aug.

Abstract

Purpose: Benzodiazepines are effective medicines for insomnia and anxiety but are commonly used beyond recommended treatment time frames, which may lead to adverse drug events. The aim of this systematic review was to critically evaluate the success of interventions used to reduce benzodiazepines and 'Z-drug' use, and the impact of these interventions on clinical outcomes in older adults.

Methods: A search was conducted in PubMed, Embase, Informit, International Pharmaceutical Abstracts, Scopus, PsychINFO, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL. Studies conducted in older adults (≥65 years) and published between January 1995 and July 2015 were included. Two authors independently reviewed all articles for eligibility and extracted the data.

Results: Seven studies of benzodiazepines and Z-drug withdrawal were identified. Benzodiazepine discontinuation rates were 64.3% in one study that employed pharmacological substitution with melatonin and 65.0% in a study that employed general practitioner-targeted intervention. Mixed interventions including patient education and tapering (n = 2), pharmacological substitution with psychological support (n = 1) and tapering with psychological support (n = 1) yielded discontinuation rates between 27.0 and 80.0%. Five studies measured clinical outcomes following benzodiazepine discontinuation. Most (n = 4) observed no difference in prevalence of withdrawal symptoms or sleep quality, while one study reported decline in quality of life in those who continued taking benzodiazepine vs. those who discontinued over 8 months.

Conclusions: Current evidence shows that benzodiazepine withdrawal is feasible in the older population, but withdrawal rates vary according to the type of intervention. As the benefits and sustainability of these interventions are unclear, further studies should be conducted to assess this.

Keywords: Benzodiazepines; Deprescribing; Older adults; Z-drugs.

PubMed Disclaimer

References

    1. Rev Bras Psiquiatr. 2008 Mar;30(1):7-11 - PubMed
    1. Age Ageing. 2010 May;39(3):313-9 - PubMed
    1. Trials. 2015 Jun 10;16:266 - PubMed
    1. Int J Psychiatry Clin Pract. 2010 Jun;14(2):78-87 - PubMed
    1. Intern Med J. 2014 Jan;44(1):57-64 - PubMed

Publication types

MeSH terms

LinkOut - more resources