Khan Safiyyah M, Kasagga Alousious, Verma Anushka, Saraya Eiman, Haque Mehjabin S, Senaratne Mithum, Khan Safeera
Medicine, Basaveshwara Medical College and Hospital, Chitradurga, IND.
Pathology, Peking University, Beijing, CHN.
Cureus. 2025 May 18;17(5):e84318. doi: 10.7759/cureus.84318. eCollection 2025 May.
Benzodiazepines (BZDs) are widely used anxiolytics for treating various psychiatric conditions and for procedures requiring conscious sedation. Despite their therapeutic benefits, there is concern about their paradoxical effects, particularly the potential increase in suicidal ideation and suicide completion. This systematic review examines the extent to which benzodiazepines contribute to, cause, or exacerbate suicidal ideation and suicide completion. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we conducted a systematic review of literature from databases including PubMed, PubMed Central (PMC), and PubPsych. Search terms related to benzodiazepines and suicide were used, yielding 7,961 articles. After removing duplicates and applying inclusion and exclusion criteria, 587 articles were screened, leading to a final selection of six articles. These studies underwent rigorous quality assessment using various tools. The review highlighted several key findings. Moderate benzodiazepine use with concomitant psychotherapy or antidepressants was associated with reduced suicide risk. Concurrent use of opioids and benzodiazepines significantly elevated the risk of suicide attempts and intentional self-harm. Benzodiazepine use was linked to increased suicide risk in vulnerable groups, including those with pre-existing mental health conditions. Benzodiazepines should be prescribed with caution, ideally for short-term use until antidepressant effects manifest. Close monitoring for addiction, withdrawal, and suicidal ideation is essential. Prescribers must be aware of the increased risks when benzodiazepines are used in conjunction with opioids or in patients with heightened vulnerability to suicide. Effective weaning programs and risk assessment tools are crucial to mitigate these risks and ensure patient safety.
苯二氮䓬类药物（BZDs）是广泛使用的抗焦虑药物，用于治疗各种精神疾病以及需要清醒镇静的手术。尽管它们具有治疗益处，但人们担心它们会产生矛盾效应，特别是自杀意念和自杀行为的潜在增加。本系统评价考察了苯二氮䓬类药物在多大程度上促成、导致或加剧自杀意念和自杀行为。我们遵循系统评价和Meta分析的首选报告项目（PRISMA）2020指南，对包括PubMed、PubMed Central（PMC）和PubPsych在内的数据库中的文献进行了系统评价。使用了与苯二氮䓬类药物和自杀相关的检索词，共检索到7961篇文章。在去除重复项并应用纳入和排除标准后，筛选了587篇文章，最终选定了6篇文章。这些研究使用各种工具进行了严格的质量评估。该评价突出了几个关键发现。适度使用苯二氮䓬类药物并同时进行心理治疗或使用抗抑郁药与自杀风险降低相关。同时使用阿片类药物和苯二氮䓬类药物显著增加了自杀未遂和故意自伤的风险。使用苯二氮䓬类药物与弱势群体（包括已有心理健康问题的人群）的自杀风险增加有关。应谨慎开具苯二氮䓬类药物的处方，理想情况下短期使用，直到抗抑郁作用显现。密切监测成瘾、戒断和自杀意念至关重要。开处方者必须意识到，当苯二氮䓬类药物与阿片类药物联合使用或用于自杀风险较高的患者时，风险会增加。有效的撤药方案和风险评估工具对于降低这些风险和确保患者安全至关重要。
