Dependence on hypnotics: a comparative study between chronic users of benzodiazepines and Z-drugs

Abstract

Objective: To evaluate dependence among chronic benzodiazepine and Z-drug users in Brazil. Methods: Chronic users of benzodiazepines (n=94), Z-drugs (n=74), or both (n=11) were recruited from the community, underwent a psychiatric evaluation and completed self-report instruments on hypnotic dependence, insomnia, anxiety, and depression. Users of benzodiazepines and Z-drugs were compared using t-tests, and logistic regression models were employed to explore significant predictors of a dependence diagnosis. Results: There was no difference in the prevalence of dependence among benzodiazepine (77.2%) and Z-drug (69.4%) users. Benzodiazepine users reported increased psychosocial aspects of dependence, anxiety, and depression. Preoccupation with the availability of medication (prevalence ratio ) and insomnia (PR = 1.10 [1.02-1.19]) were associated with a diagnosis of dependence (n=175). Conclusion:The prevalence of dependence was similar among both drug classes. The increased self-reported dependence, anxiety, and depression among benzodiazepine users may be due to behavioral rather than pharmacological aspects of medication use. Behaviors related to hypnotic use were important predictors of dependence.

Benzodiazepines and z-drugs - between treatment effectiveness and the risk of addiction

“…The study provides valuable clues about the differences between benzodiazepine and Z-drug users, highlighting the higher risk of addiction associated with long-term benzodiazepine use. The results of the study underscore the importance of caution when prescribing hypnotics to patients and the need for regular monitoring to ensure safe and responsible use of these drugs [30].…”

“…In addition, it is important to monitor patients using these drugs long-term to prevent side effects associated with long-term use. According to DF Curado, VV de Barros, AR Noto et al ( 2022), long-term use of BZD led to a higher risk of substance dependence compared to NBZD [30]. The publication sheds light on the problem of addiction to sleeping pills.…”

Papel do farmacêutico no combate ao uso indiscriminado de benzodiazepínicos: uma revisão de literatura

“…Elas possuem um período de uso curto (2-4 semanas), causando indução do sono e exercendo função relaxante muscular, como anteriormente reportado. Caso a administração do fármaco persista, o usuário tende a entrar em um quadro de dependência onde mesmo ao final do tratamento a administração do medicamento se mantém contínua objetivando alcançar as sensações fornecidas pela medicação (Braga et al, 2016;Curado et al, 2021).…”

Dispensing of psychotropic drugs in the Brazilian capital city before and during the COVID-19 pandemic (2018–2020)

“…Epidemiological studies can generate quality and reliable information on how and to what extent the pandemic has influenced the mental state of communities. Although the utilization of antidepressants, anxiolytics, and hypnotics was high in Brazil, mainly to benzodiazepines and Z-drugs (Madruga et al, 2019;Curado et al, 2022), COVID-19's pandemic affects the individuals' physical health, the pandemic's social restriction measures have impacted people's mental health (COVID-19 Mental Disorders Collaborators, 2021;Organização Pan American Health Organization, 2020;Saavedra et al, 2020).…”

“…For instance, the COVID-19 Mental Disorders Collaborators' systematic review analyzed 204 countries and territories in 2020 and revealed, among others, that people's reduced mobility was associated with an increase in major depressive disorder (p = 0.029) and anxiety (p = 0.0001) prevalence (COVID-19 Mental Disorders Collaborators, 2021). Among the psychotropic drugs regulated in Brazil that could highlight the potential and actual consequences of the COVID-19 pandemic on people's mental health are antidepressants and anxiolytics (Madruga et al, 2019;Curado et al, 2022).…”