Researchers Uncover the Safest Approach to Utilize Valium and Ativan

Recent research has unveiled a safer approach to the use of benzodiazepines, notably Valium and Ativan, by advocating intermittent rather than continuous usage. This breakthrough has demonstrated a significant reduction in side effects and associated health risks, particularly among older adults. These findings challenge established prescription practices and emphasize the importance of carefully managing these widely prescribed medications.

Over six decades since their introduction, medical experts have finally amassed substantial evidence supporting the notion that intermittent usage of benzodiazepines, such as Valium and Ativan, as opposed to continuous administration, results in fewer side effects and a notable decrease in falls, hospital admissions, and fatalities.

Benzodiazepines, including Ativan, Librium, and Valium, were initially introduced in the early 1960s to treat anxiety and insomnia. By 1977, they had become the most prescribed medications globally, and they are still considered reasonably safe and effective, although some patients developed tolerance and dependency issues. Moreover, concerns about falls and fractures persist, particularly among older individuals. While these drugs are still widely used, modern antidepressants, such as SSRIs, have become more common prescriptions.

Diverse Perspectives and Limited Research

Most studies examining benzodiazepines (“benzos”) have only tracked health outcomes for up to 6 to 8 weeks. This limited scope has led to conflicting opinions among healthcare professionals. Some clinicians argue that benzodiazepine use should be restricted to a few weeks to mitigate the risks of tolerance and dependence, or even that it should not be prescribed to individuals over 65. In contrast, others advocate for long-term use as a viable option.

This research was presented at the ECNP Congress in Barcelona following recent peer-reviewed publication. Lead researcher Dr. Simon Davies, from the Centre for Addiction and Mental Health in Toronto, Canada, stated:

“Using a vast dataset from Ontario, Canada, we examined how individuals over the age of 65 with anxiety or insomnia actually used benzodiazepines after starting them. We also correlated this with other health outcomes. This involved studying 57,000 people who regularly took benzos on most days over six months (chronic users) and 113,000 matched individuals who used the medications over a similar period but with breaks during which they did not take benzodiazepines (intermittent users). We then followed both groups for an additional year. The results were remarkable.

Our findings indicate that transitioning from chronic to intermittent benzodiazepine use could result, over one year, in a 20% reduction in hip fractures (33% less in men), a 7.5% decrease in falls requiring hospitalization or emergency visits, and a 24% decrease in the likelihood of requiring long-term care.”

Note: It is essential to consider both percentages and real numbers. There were twice as many intermittent benzo users as matched chronic benzo users, so the real numbers need to be adjusted accordingly. There were 3592 hospitalizations or emergency department visits resulting from falls in the intermittent group and 2906 in the chronic group. If the chronic group had the same number of participants as the intermittent group, we would expect 5200 hospitalizations/emergency department visits. Similar calculations apply to hip fractures and other long-term outcomes.

Implications for Elderly Patients

These consequences are not confined to the short term. Falls are the leading cause of death for individuals over 65 in the United States and Canada. More than one in five elderly individuals who suffer a hip fracture succumbs within a year.

Dr. Davies added, “This study suggests that, whenever possible, individuals over the age of 65 with anxiety or insomnia who are using Ativan, Valium, or another benzodiazepine long-term should consider not staying on the drugs continuously. In practical terms, some may not be able or willing to make this change. However, these results provide a clear understanding of the additional risks of falls, fractures, emergency visits, long-term care admissions, and death associated with chronic rather than intermittent benzodiazepine use.

Naturally, these are still prescription medications, and their use should be guided by your healthcare provider.”

Professor Christian Vinkers of Amsterdam University Medical Centres commented:

“This is a highly significant study that reinforces the recommendation against long-term benzodiazepine use. The risk of falls, along with cognitive side effects and impaired driving skills, leading to the risk of road accidents, makes chronic benzodiazepine overuse a public health concern. While there is a small subset of patients who may benefit from long-term use, it is reasonable to assume that this group is currently too large.”

It is important to note that Professor Vinkers was not involved in this research.

Event: 36th European College of Neuropsychopharmacology (ECNP) conference

Frequently Asked Questions (FAQs) about Benzodiazepine Safety

More about Benzodiazepine Safety

• Medical News Today – Benzodiazepines
• Centre for Addiction and Mental Health
• European College of Neuropsychopharmacology (ECNP)