A new study by the American Heart Association analyzed initial excess supply and longitudinal trends in benzodiazepine use in Ischemic stroke survivors.
“Our research at the Center for Value-Based Healthcare and Sciences at Massachusetts General Brigham focuses on ensuring people living with dementia and stroke receive high quality care,” study author Julianne D. Brooks told us. “We have an amazing team of clinicians, statisticians, and scientists dedicated to improving healthcare quality. Our study investigates the use of benzodiazepines (Xanax, Valium, and others) after stroke in the population over 65. We are hoping to understand trends in the use of these medications.”
Based on previous published research, it was known that the use of benzodiazepines in the Medicare population is around 20%, despite being listed on the American Geriatrics Society list of potentially inappropriate medication use in older adults.
“This study was motivated by physicians who see first-hand how difficult it can be for patients to stop taking benzodiazepines after they are used chronically,” Brooks told us. “We are living in an era of substance use disorder. Overprescribing and oversupply of controlled substances is a concern as it can lead to dependence and misuse. The use of benzodiazepines for the population over 65 is not recommended by the American Geriatric Society and can lead to falls, confusion, memory problems and even increased risk of dementia.”
For this study, the research team wanted to take a broad approach to understanding prescription patterns of benzodiazepine after stroke using a national dataset. Despite guidelines from the American Geriatric Society cautioning against prescribing benzodiazepines in patients over age 65, the study data indicates that more than half of people prescribed benzodiazepine received an initial prescription of two weeks or more.
“For medications intended to be prescribed ‘as needed’, we would except small supplies such as three or four tablets at a time,” Brooks told us. “We were surprised to see supplies of 30 days or more for initial prescriptions.”
Researchers also found that benzodiazepine prescriptions decreased slightly in 2021.
“It will be interesting to see if this trend continues,” Brooks told us. “Our study highlights that despite recommendations against the use of benzodiazepines in older adults, it remains a problem. More efforts are needed to ensure appropriate prescriptions and adherence to recommendations from the American Geriatric Society.”
Brooks explained that patients should understand that according to the American Geriatric Society, older adults have increased sensitivity and decreased metabolism of benzodiazepines. When taking these medications, users are exposed to risk of misuse and physical dependence. Benzodiazepine use is associated with an increased risk of cognitive impairment, delirium, falls, fractures and motor vehicle crashes.