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Initiation and long-term use of benzodiazepines and Z-drugs in bipolar disorder.
Bipolar Disord. 2018 11; 20(7):634-646
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Louise Wingård
Heidi Taipale
Johan Reutfors
Anna Westerlund
Robert Bodén
Jari Tiihonen
Antti Tanskanen
Morten Andersen
Author Affiliation
Centre for Pharmacoepidemiology (CPE), Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Bipolar Disord. 2018 11; 20(7):634-646
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Accidental Falls - prevention & control
Benzodiazepines - administration & dosage - adverse effects
Bipolar Disorder - diagnosis - drug therapy - epidemiology - psychology
Cognition - drug effects
Cohort Studies
Inappropriate Prescribing - adverse effects - prevention & control - statistics & numerical data
Logistic Models
Long Term Adverse Effects - chemically induced - diagnosis - prevention & control
Middle Aged
Risk assessment
Sleep Aids, Pharmaceutical - administration & dosage - adverse effects
Sweden - epidemiology
Increasing evidence points to the harmful effects of long-term benzodiazepine treatment. Our objective was to study the incidence of, and predictors for, long-term use of benzodiazepines and Z-drugs in bipolar disorder.
We conducted a population-based cohort study, using data from Swedish national registers. Swedish residents aged 18-75 years with a recorded diagnosis of bipolar disorder or mania between July 2006 and December 2012, and no history of benzodiazepine/Z-drug use in the past year, were included. Patients were followed for 1 year with regard to prescription fills of benzodiazepines/Z-drugs. Initiators were followed for another year during which continuous use for >6 months was defined as "long-term". Patient and prescription characteristics were investigated as potential predictors for long-term use in multivariate logistic regression models.
Out of the 21 883 patients included, 29% started benzodiazepine/Z-drug treatment, of whom one in five became long-term users. Patients who were prescribed clonazepam or alprazolam had high odds for subsequent long-term use (adjusted odds ratios [aORs] 3.78 [95% confidence interval (CI) 2.24-6.38] and 2.03 [95% CI 1.30-3.18], respectively), compared to those prescribed diazepam. Polytherapy with benzodiazepines/Z-drugs also predicted long-term use (aOR 2.46, 95% CI 1.79-3.38), as did age =60 years (aOR 1.93, 95% CI 1.46-2.53, compared to age
PubMed ID
29450954 View in PubMed
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