Benzodiazepine-Related Mortality Risk Called into Question

Benzodiazepine use might not be associated with an increase in all-cause mortality risk, according to the findings of a recent study.

In the retrospective cohort study, researchers identified 1,686,410 patients who initiated benzodiazepine therapy and 1,930,159 patients who underwent a medical visit but did not receive benzodiazepine between July 2004 and December 2013 using the Optum Clinformatics Datamart database. Patient data were linked to the Social Security Administration Death Master File to determine all-cause mortality.
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A total of 5061 individuals who received benzodiazepine and 4691 individuals who did not receive benzodiazepine died during the 6 months of follow-up. The researchers observed a 4% to 9% mortality increase that was associated with the start of benzodiazepine treatment for follows-up of 12 and 48 months, and in subgroups of younger patients and those who received short acting agents.

Secondary analyses that compared patients who started benzodiazepine with an active comparator, such as selective serotonin reuptake inhibitor antidepressants, showed that those who received benzodiazepine had a 9% increased mortality risk.

“This large population based cohort study suggests either no increase or at most a minor increase in risk of all-cause mortality associated with benzodiazepine initiation,” the researchers concluded. “If a detrimental effect exists, it is likely to be much smaller than previously stated and to have uncertain clinical relevance.”

“Residual confounding likely explains at least part of the small increase in mortality risk observed in selected analyses.”

—Melissa Weiss

Reference:

Patorno E, Glynn RJ, Levin R, Lee MP, Huybrechts KF. Benzodiazepines and risk of all cause mortality in adults: cohort study [published online July 6, 2017]. BMJ. https://doi.org/10.1136/bmj.j2941.