Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Japan.
Department of Sleep-wake disorders, NIMH, National Center of Neurology and Psychiatry, Tokyo, Japan.
Neuropsychopharmacol Rep. 2021 Mar;41(1):14-25. doi: 10.1002/npr2.12149. Epub 2020 Dec 1.
Benzodiazepine receptor agonists (BZ-RAs) are frequently prescribed to treat insomnia; however, their long-term use is not recommended. To introduce an appropriate pharmaco-therapy, the current state and background factors of BZ-RAs' dependence must be elucidated. In this study, we developed a Japanese version of the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ-J) and conducted a study of BZ-RAs' use disorder.
The Bendep-SRQ-J was created with permission from the original developer. Subjects were inpatients and outpatients receiving BZ-RAs between 2012 and 2013. Clinical data collected were Bendep-SRQ-J scores, sleep disorders for which BZ-RAs were prescribed, physical comorbidities, psychotropic drugs, and lifestyle factors. Logistic analysis was performed to extract factors associated with severe symptoms.
Of the 707 patients prescribed BZ-RAs, 324 had voluntarily tapered or discontinued their drugs. Logistic analysis showed that the total number of drugs administered in the last 6 months correlated with both worsening of symptoms or conditions. This was more notable among younger patients, and the proportion of patients with severe symptoms or conditions increased with the increasing number of drugs.
Using the Bendep-SRQ-J, we elucidated the current state of BZ-RA dependence. Nearly half of the patients were non-compliant. The proportion of patients with severe symptoms or disease conditions increased with the increase in the number of drugs administered. These findings highlight the need for clinicians to be aware of the likelihood of benzodiazepine dependence, especially in young patients and patients prescribed multiple hypnotics.
苯二氮䓬受体激动剂(BZ-RAs)常用于治疗失眠,但不建议长期使用。为了引入适当的药物治疗,必须阐明 BZ-RAs 依赖的现状和背景因素。在这项研究中,我们开发了一种苯二氮䓬依赖自评问卷(Bendep-SRQ-J)的日文版,并对 BZ-RAs 的使用障碍进行了研究。
Bendep-SRQ-J 是在原开发者的许可下创建的。受试者为 2012 年至 2013 年期间接受 BZ-RAs 治疗的住院和门诊患者。收集的临床数据包括 Bendep-SRQ-J 评分、开具 BZ-RAs 的睡眠障碍、身体合并症、精神药物和生活方式因素。进行逻辑分析以提取与严重症状相关的因素。
在接受 BZ-RAs 治疗的 707 名患者中,有 324 名患者自愿减少或停止用药。逻辑分析表明,过去 6 个月内使用的药物总数与症状或病情恶化相关。这在年轻患者中更为明显,且随着药物数量的增加,有严重症状或疾病的患者比例增加。
使用 Bendep-SRQ-J,我们阐明了 BZ-RA 依赖的现状。近一半的患者不遵医嘱。有严重症状或疾病的患者比例随着所使用药物数量的增加而增加。这些发现强调了临床医生需要意识到苯二氮䓬类药物依赖的可能性,尤其是在年轻患者和开具多种催眠药物的患者中。