Benzodiazepine discontinuation and patient outcome in a chronic geriatric medical/psychiatric unit: A retrospective chart review

Yuma Yokoi, Meenal Misal, Esther Oh, Michele F Bellantoni, Paul B Rosenberg

Research output: Contribution to journalArticle

Abstract

Aim: A substantial number of elderly patients take benzodiazepines (BZD) regularly despite concerns about toxicity and possible dependence, and there are relatively few data to guide clinicians' decisions regarding discontinuing benzodiazepines in the elderly. Methods: We carried out a retrospective chart review of 75 elderly patients admitted to a chronic medical/psychiatric unit who were taking a standing dose of benzodiazepines on admission, comparing 40 patients who discontinued benzodiazepines versus 35 who did not discontinue. Purpose: We examined the association of BZD discontinuation versus continuation with clinical outcomes on discharge, and further examined clinical characteristics associated with BZD discontinuation. Results: Discontinuers had shorter length of stay without evidence of worse cognitive and functional outcome except a trend toward increased incidence of agitation. Logistic regression models suggested anxiety, higher age and higher dose of antidepressants at the beginning were significantly related to successful discontinuation during admission after regression. Conclusion: These data imply that BZD withdrawal during admission can be safe and feasible in many elderly frail patients, and that withdrawal might be associated with shorter duration of chronic hospitalization.

Original languageEnglish (US)
Pages (from-to)388-394
Number of pages7
JournalGeriatrics and Gerontology International
Volume14
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Geriatric Psychiatry
geriatrics
Benzodiazepines
withdrawal
regression
hospitalization
Logistic Models
incidence
logistics
Frail Elderly
anxiety
Antidepressive Agents
trend
Psychiatry
Length of Stay
Hospitalization
Anxiety
evidence
Incidence

Keywords

  • Aged
  • Benzodiazepines
  • Dementia
  • Outcome assessment
  • Substance withdrawal syndrome

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology
  • Health(social science)
  • Medicine(all)

Cite this

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abstract = "Aim: A substantial number of elderly patients take benzodiazepines (BZD) regularly despite concerns about toxicity and possible dependence, and there are relatively few data to guide clinicians' decisions regarding discontinuing benzodiazepines in the elderly. Methods: We carried out a retrospective chart review of 75 elderly patients admitted to a chronic medical/psychiatric unit who were taking a standing dose of benzodiazepines on admission, comparing 40 patients who discontinued benzodiazepines versus 35 who did not discontinue. Purpose: We examined the association of BZD discontinuation versus continuation with clinical outcomes on discharge, and further examined clinical characteristics associated with BZD discontinuation. Results: Discontinuers had shorter length of stay without evidence of worse cognitive and functional outcome except a trend toward increased incidence of agitation. Logistic regression models suggested anxiety, higher age and higher dose of antidepressants at the beginning were significantly related to successful discontinuation during admission after regression. Conclusion: These data imply that BZD withdrawal during admission can be safe and feasible in many elderly frail patients, and that withdrawal might be associated with shorter duration of chronic hospitalization.",
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AU - Bellantoni, Michele F

AU - Rosenberg, Paul B

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N2 - Aim: A substantial number of elderly patients take benzodiazepines (BZD) regularly despite concerns about toxicity and possible dependence, and there are relatively few data to guide clinicians' decisions regarding discontinuing benzodiazepines in the elderly. Methods: We carried out a retrospective chart review of 75 elderly patients admitted to a chronic medical/psychiatric unit who were taking a standing dose of benzodiazepines on admission, comparing 40 patients who discontinued benzodiazepines versus 35 who did not discontinue. Purpose: We examined the association of BZD discontinuation versus continuation with clinical outcomes on discharge, and further examined clinical characteristics associated with BZD discontinuation. Results: Discontinuers had shorter length of stay without evidence of worse cognitive and functional outcome except a trend toward increased incidence of agitation. Logistic regression models suggested anxiety, higher age and higher dose of antidepressants at the beginning were significantly related to successful discontinuation during admission after regression. Conclusion: These data imply that BZD withdrawal during admission can be safe and feasible in many elderly frail patients, and that withdrawal might be associated with shorter duration of chronic hospitalization.

AB - Aim: A substantial number of elderly patients take benzodiazepines (BZD) regularly despite concerns about toxicity and possible dependence, and there are relatively few data to guide clinicians' decisions regarding discontinuing benzodiazepines in the elderly. Methods: We carried out a retrospective chart review of 75 elderly patients admitted to a chronic medical/psychiatric unit who were taking a standing dose of benzodiazepines on admission, comparing 40 patients who discontinued benzodiazepines versus 35 who did not discontinue. Purpose: We examined the association of BZD discontinuation versus continuation with clinical outcomes on discharge, and further examined clinical characteristics associated with BZD discontinuation. Results: Discontinuers had shorter length of stay without evidence of worse cognitive and functional outcome except a trend toward increased incidence of agitation. Logistic regression models suggested anxiety, higher age and higher dose of antidepressants at the beginning were significantly related to successful discontinuation during admission after regression. Conclusion: These data imply that BZD withdrawal during admission can be safe and feasible in many elderly frail patients, and that withdrawal might be associated with shorter duration of chronic hospitalization.

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