Long-Term Benzodiazepine Use Risky for Patients With Schizophrenia

Chronic high doses of benzodiazepines were associated with up to a 70% increased risk of death compared with no exposure in an observational 5-year follow-up study of more than 20,000 patients with schizophrenia in Sweden.

Researchers published their findings in the American Journal of Psychiatry.

The study's authors used nationwide databases in Sweden to identify 21,492 patients 16 to 65 years old with a schizophrenia diagnosis. They looked at the relationship between cumulative exposure to benzodiazepines, antipsychotics, and antidepressants and risk of death from 2006 through 2010.

Although guidelines recommend patients not receive benzodiazepines for longer than 1 month, the researchers found that much of the study population had been taking the medications for years. They suspect usage rates for long-term benzodiazepine use are likely even higher in the United States.

“Since patients with anxiety and depressive symptoms may have a higher intrinsic risk of death, the finding for benzodiazepines may be attributable to some extent to residual confounding,” researchers noted.

However, in contrast to the heightened mortality risk associated with high cumulative exposure to benzodiazepines, researchers reported a 15%–40% lower overall mortality associated with moderate and high exposure to antipsychotics and antidepressants.

Compared to no exposure, both moderate and high exposure to antipsychotics were linked with substantially lower overall mortality, according to the study. Along the same lines, “moderate antidepressant exposure was associated with a lower mortality, and high exposure, even lower,” researchers wrote.

—Jolynn Tumolo

Reference

1. Tiihonen J, Mittendorfer-Rutz E, Torniainen M, Alexanderson K, Tanskanen A. Mortality and cumulative exposure to antipsychotics, antidepressants, and benzodiazepines in patients with schizophrenia: an observational follow-up study. The American Journal of Psychiatry. 2015 Dec. 7. [Epub ahead of print].