School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Address:No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan.
Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Address: No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Affect Disord. 2020 Jun 15;271:215-223. doi: 10.1016/j.jad.2020.03.077. Epub 2020 Apr 19.
Benzodiazepines (BZDs) have been widely used to treat anxiety; however, the risk of adverse health effects caused by their long-term use is high. This study examined the factors associated with the duration and higher daily dose of BZDs use among a population with anxiety or depressive disorders.
A cross-sectional study design was used. Patients from a psychiatric outpatient department who had been prescribed BZDs were recruited. Data were collected from 250 patients.
Nearly 94% of patients were long-term BZDs users. The mean duration of BZDs use was 5.5 years; and mean defined daily dose (DDD) of BZDs use, converted to diazepam milligram equivalent (DDD), was 1.53 DME-DDD. Patients who knew more about alternative treatments were less prone to use BZD longer. Patients aged 65 years or older and those with difficulty falling asleep were more prone to use BZDs longer. Patients who were currently taking BZDs at higher daily dose were those who felt more depressed, prescribed second generation antipsychotics, suffered from disrupted sleep, less aware of alternative treatments, had comorbid chronic physical illness, and were current smokers.
The cross-sectional study design limited its ability to confirm causal relationships.
Long-term and excessive daily dose of BZDs use in patients with depressive or anxiety disorders needs to be noted. Providing information or program of non-pharmacological treatment in reducing anxiety and improving specific sleep disturbance is suggested. Elderly, suffering from depressive mood, had comorbid chronic physical illness need to be targeted for further intervention.
苯二氮䓬类药物(BZDs)已广泛用于治疗焦虑症,但长期使用会带来较高的健康风险。本研究旨在探讨与焦虑或抑郁障碍患者 BZD 用药时间长和日剂量高相关的因素。
采用横断面研究设计,招募精神科门诊开具 BZD 的患者。共纳入 250 例患者,收集数据。
近 94%的患者为长期 BZD 使用者,BZD 用药时间的平均长度为 5.5 年;以地西泮等效剂量(DDD)换算的平均 BZD 日剂量为 1.53 DME-DDD。对替代治疗了解更多的患者更不易长期使用 BZD。65 岁及以上患者和入睡困难患者更易长期使用 BZD。目前使用更高日剂量 BZD 的患者更易感到抑郁、被开具第二代抗精神病药物、存在睡眠障碍、对替代治疗的认知度更低、合并慢性躯体疾病和当前吸烟。
横断面研究设计限制了其对因果关系的确认能力。
需要关注抑郁或焦虑障碍患者中 BZD 的长期、高日剂量使用情况。建议提供非药物治疗相关信息或项目,以减轻焦虑并改善特定的睡眠障碍。对于老年、情绪低落、合并慢性躯体疾病的患者,需要进行进一步的干预。