Doctors Unveil the Safest Administration Method for Valium and Ativan

Recent studies indicate that intermittent use of benzodiazepines significantly mitigates side effects and health risks like falls and hospitalizations, more so in older adults. These findings question existing prescription habits and underscore the need for cautious administration of these frequently used drugs.

More than six decades post their introduction, substantive evidence has been found for the first time endorsing that intermittent use of benzodiazepines, such as Valium and Ativan, as opposed to continuous use brings down side effects as well as a reduction in falls, hospital admissions, and deaths.

Benzodiazepines such as Ativan, Librium, and Valium were initially employed to treat anxiety and insomnia in the early 1960s. Now they rank among the most widely prescribed medications worldwide. Traditional antidepressants (like SSRIs) are gaining more ground, however, the benzodiazepines are viewed as relatively safe and effective, although issues of tolerance and dependency do arise among some patients and the elderly at risk of falls and fractures.

Predominantly, prior studies on benzodiazepines were centered on health outcomes for about six to eight weeks. Thus, the consequences of prolonged use over months and years are vaguely known. This contributes to differing opinions among clinicians. Some propose limiting benzo usage to a few weeks to steer clear of tolerance and dependency risks, or even avoid prescribing to those over 65 altogether. Others believe in long-term usage.

The research was presented at the ECNP Congress in Barcelona following a recent peer-reviewed publication. The primary researcher, Dr Simon Davies from the Centre for Addiction and Mental Health, Toronto, ON, Canada, explained their approach and their important findings.

Employing a large dataset from Ontario, Canada, they observed how those over 65 years of age with anxiety or insomnia utilized benzodiazepines. They considered 57,000 chronic users and 113,000 intermittent users and then followed both groups for a year. Their results suggest that switching from chronic to intermittent benzodiazepine use can potentially reduce hip fractures by 20%, reduce hospitalizations or emergency visits for falls by 7.5% and decrease long-term care admissions by 24%.

Elderly people are most at risk as falls are the leading cause of death for people over 65 in the US and Canada. Over one in five elderly people who sustain a hip fracture dies within a year.

Dr Davies, therefore, concludes that patients over 65 with anxiety or insomnia would fare better not staying on these drugs continuously but under a doctor's guidance.

A professor from Amsterdam University Medical Centres, Professor Christian Vinkers, called this a very crucial study, reaffirming yet again that long-term benzodiazepine use is not recommended. With the risk of falls, cognitive side effects, impaired driving skills and thus road accidents, he says, chronic overuse of benzodiazepines is a public health concern. While acknowledging that a small group of patients requires long-term use, he says that this group is most likely larger than necessary.

Professor Vinkers' comments were made independently; he was not involved in the research.

The investigation was presented at the 36th European College of Neuropsychopharmacology (ECNP) conference.