Panes Arnaud, Fourrier-Réglat Annie, Verdoux Hélène, Tournier Marie
Université Bordeaux, Inserm, Bordeaux Population Health Research Center, Pharmacoepidemiology research team, UMR 1219, 33000 Bordeaux, France.
Université Bordeaux, Inserm, Bordeaux Population Health Research Center, Pharmacoepidemiology research team, UMR 1219, 33000 Bordeaux, France; Centre hospitalier universitaire de Bordeaux, 33000 Bordeaux, France.
Presse Med. 2018 Oct;47(10):886-891. doi: 10.1016/j.lpm.2018.10.003. Epub 2018 Oct 25.
The psychiatric patients are not only particularly exposed to benzodiazepines; they may also be more vulnerable to their side effects than general population. Benzodiazepines are frequently misused in psychiatric patients in terms of duration, dose and number of concomitant medications. There is no evidence that benzodiazepines are effective against most psychiatric disorders, including depression and suicidal risk. Several studies have shown associations between benzodiazepine use and depression worsening, increased disinhibition, suicide risk, anxiety, aggression, and even mortality in patients with psychiatric disorders. Despite the common use of benzodiazepine drugs by clinicians, large and methodologically sound studies are lacking to document the patterns of benzodiazepine use in populations with psychiatric disorders and their specific risks in these patients. It is not known whether it is legitimate to apply the good practice recommendations for benzodiazepines in patients with severe psychiatric disorders.
精神病患者不仅特别容易接触到苯二氮䓬类药物；他们可能也比普通人群更容易受到其副作用的影响。在精神病患者中，苯二氮䓬类药物在用药时长、剂量和联合用药数量方面经常被滥用。没有证据表明苯二氮䓬类药物对包括抑郁症和自杀风险在内的大多数精神疾病有效。多项研究表明，使用苯二氮䓬类药物与精神疾病患者的抑郁加重、去抑制增加、自杀风险、焦虑、攻击行为甚至死亡之间存在关联。尽管临床医生普遍使用苯二氮䓬类药物，但缺乏大规模且方法合理的研究来记录精神疾病患者使用苯二氮䓬类药物的模式及其在这些患者中的特定风险。对于严重精神疾病患者应用苯二氮䓬类药物的良好实践建议是否合理尚不清楚。
