Alzheimer disease

In Alzheimer Disease, Opioids May Lower Benzodiazepine Use

Opioid initiation may help lower antipsychotic and benzodiazepine (BZDR) use among patients with Alzheimer disease (AD), according to new findings.

In a study of patients who were enrolled in the Medication use and Alzheimer's disease (MEDALZ) cohort, researchers compared patient outcomes associated with opioid initiation (n = 3327) vs non-opioid initiation (n = 3325).
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Using interrupted time series analyses, the prevalence of antipsychotic and BDZR use was compared in 30-day periods within 6 months before opioid initiation to 30-day periods 6 months later.

Antipsychotics were used by approximately 13.3% of opioid initiators before opioid initiation, 18.3% at the time of opioid initiation, and 17.3% at 6 months post-opioid initiation. In addition, the prevalence of BDZR use among opioid initiators was 27.1% at 6 months pre-opioid initiation, 28.9% at the time of opioid initiation, and 26.9% at 6 months post-opioid initiation.

Ultimately, the researchers found that opioid initiation was associated with a 0.3% and 0.4% drop per month in antipsychotic and BZDR use, respectively, until the end of follow-up.

The researchers noted that, although opioid initiation vs non-opioid initiation was associated with an immediate increase in prevalence of 1.9 percentage points for antipsychotic use and 1.6 percentage points for BZDR use, they observed a comparative decrease of 0.5 percentage points per month for antipsychotics and 0.4 percentage points per month for BZDR use until the end of follow-up.

“Our results suggest that opioid initiation may reduce antipsychotic and BZDR use among persons with AD,” the researchers concluded.

—Christina Vogt

Reference:

Hamina A, Lavikainen P, Tanskanen A, et al. Impact of opioid initiation on antipsychotic and benzodiazepine and related drug use among persons with Alzheimer's disease [Published online March 21, 2018]. Int Psychogeriatr. https://doi.org/10.1017/S1041610217002897.