Professor Md Rafiqul Islam, Professor and Head, Department of Medicine, North Bengal Medical College, Sirajganj, Bangladesh; E-mail:
Mymensingh Med J. 2024 Oct;33(4):1121-1130.
Although comprehensive epidemiological data related to long term use and abuse of benzodiazepine (BZD) in our country is scarce, undocumented clinical observation suggests that the prevalence is quite high and constitutes a significant public health problem. This cross-sectional study was carried out in the Department of Medicine, Shaheed Ziaur Rahman Medical College hospital, Bogra, from 1st October 2015 to 31st March 2016. The objectives of the study were to evaluate the indication, dosage, duration and untoward effects of use of benzodiazepine for one month or longer among the patients attending the inpatient and outpatient departments of medicine. A total of 100 cases of long term benzodiazepine users aged between 18 to 72 years with mean age of 44.0±15.02 years were taken for the study. Male to female ratio of the cases was 1.08:1.00, 97.0% were Muslims, 96.0% were married; 77.0% were rural dwellers. Fifty four (54.0%) cases were from middle class society and 39.0% were housewives by occupation. The benzodiazepine dosage ranged from <5mg to 10mg equivalent to diazepam, with mean dose of 7.5±1.71 and the duration ranged from 1-60 months. Benzodiazepine tolerance was found in 21.0% and dependence in 18.0%. The common reason for taking was benzodiazepine for long duration was the different anxiety disorders in 63.0% followed sleep disturbance in 33.0%. Common cause of long term continuation reported by the respondents was rapid relief of symptoms (51.0%) and lack of awareness (21.0%). In 56.0% cases, the drugs were prescribed by providers other than registered physicians. Only 23.0% of patients were counseled beforehand regarding the probable hazards of long term use of the drugs and the counseling were provided only by registered physicians. In conclusion, it can be said that, large scale epidemiologic studies are warranted to evaluate the weight of burden of benzodiazepines abuse in our community and the needs for changes in clinical approach.
尽管我国有关苯二氮䓬（BZD）长期使用和滥用的综合流行病学数据稀缺，但未经记录的临床观察表明，其流行率相当高，构成了一个重大的公共卫生问题。这项横断面研究于 2015 年 10 月 1 日至 2016 年 3 月 31 日在博格拉谢赫·齐亚乌尔·拉赫曼医学院医院内科进行。研究目的是评估在我院内科门诊和住院部就诊的患者中，使用苯二氮䓬一个月或更长时间的指征、剂量、持续时间和不良反应。共纳入 100 例年龄在 18 至 72 岁之间、平均年龄为 44.0±15.02 岁的长期使用苯二氮䓬的患者。病例中男女比例为 1.08:1.00，97.0%为穆斯林，96.0%已婚；77.0%为农村居民。54（54.0%）例来自中产阶级社会，39.0%为家庭主妇。苯二氮䓬剂量范围为<5mg 至 10mg 等效于地西泮，平均剂量为 7.5±1.71，持续时间范围为 1-60 个月。发现 21.0%的患者有苯二氮䓬耐受性，18.0%的患者有苯二氮䓬依赖性。63.0%的患者长期服用苯二氮䓬的常见原因是不同的焦虑障碍，33.0%的患者是睡眠障碍。受访者长期继续服用的常见原因是症状迅速缓解（51.0%）和缺乏意识（21.0%）。在 56.0%的情况下，药物是由注册医生以外的提供者开具的。只有 23.0%的患者在之前接受过关于长期使用该药物可能带来的危害的咨询，并且只有注册医生提供了咨询。总之，可以说，需要进行大规模的流行病学研究来评估我们社区中苯二氮䓬滥用的负担，并评估对临床方法进行改变的必要性。
