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5PSQ-043 Benzodiazepines and hypnotic antipsychotics in a psychiatric hospital
  1. J Velasco Costa,
  2. JM Peñalver Gonzalez,
  3. EM Robles Blazquez,
  4. M Martínez De Guzmán
  1. Hospital Psiquiatrico Roman Alberca, Pharmacy, El Palmar,Murcia, Spain


Background and importance Benzodiazepines are the most prescribed psychotropic drugs as anxiolytics (with excessive sedation as the main adverse effect), which leads to their possible abuse and dependence, and constitutes a major problem especially among patients who are under regular psychopharmacological treatment.

Aim and objectives To analyse the prevalence of prescription benzodiazepines (BZD) prescribed in a psychiatric hospital, as well as their association with other hypnotic drugs.

Material and methods Descriptive cross-sectional study of the prescriptions of admitted patients. A database was created with the information: history, sex, age, diagnosis, prescribed BZD and concomitant sedative antipsychotics. Statistical analysis was performed with the SPSS program and degree of significance p≤0.05.

Results 150 patients, 87 (58.0%) men and 63 (42.0%) women, with a mean age of 44.2±12.8 years.

Mean BZD/patient of 1.9±0.8. Total number of prescriptions with BZD was 138 (92.0%), of which 2 (2.3%) corresponded to BZD of short duration, 78 (56.5%) to BZD of intermediate duration and 102 (73.9%) at least one long-acting BZD.

43.3% (n=65) received monotherapy, and a combination of hypnotic BZD plus anxiolytic 49.3% (n=74) (χ2=24.1; p<0.01).

Prevalence of each BZD: use as hypnotics (flurazepam, lormetazepam and ketazolam) 98 (65.3%) and as anxiolytics (clorazepate, diazepam and lorazepam) 115 (76.7%). 63.9% of prescriptions were conditional on whether the patient needed them.

The significantly (p<0.05) hypnotic antipsychotic most used in conjunction with BZD was clotiapine 35 (23.3%), followed by levomepromazine 9 (6.0%), quetiapine 5 (3.3%), olanzapine 3 (2.0%) and haloperidol 2 (1.3%).

Conclusion and relevance High percentage of long-acting BZD prescriptions (73.9%). The most frequent side effects when using BZD with their long-half life are when the duration of the treatment is prolonged and if they are combined with other psychoactive substances such as alcohol or toxic substances.

BZDs are significantly more associated with clotiapine than other antipsychotics with a sedative profile such as levomepromazine, quetiapine or olanzapine.

The available scientific evidence indicates that BZDs are effective in the short-term treatment of anxiety and insomnia, and their prolonged use is considered, in general, inappropriate as it is not exempt from risks: mental and physical dependence, tolerance and withdrawal syndrome, traffic accidents, falls, hip fractures and cognitive impairment.

Possible interventions aimed at suspending BDZs include: substitution with other drugs, psychological support, oral recommendations, written review of medication guidelines, educational interventions, and dose reduction.

Conflict of interest No conflict of interest

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