PLOS MED: Use medicine with caution!

Hypnotics are one of the most commonly prescribed drugs used by the elderly
.
In the United States, the three most common prescription drugs for insomnia are benzodiazepines, class Z drugs, and low-dose trazodone

.

In the United States, the three most common prescription drugs for insomnia are benzodiazepines, class Z drugs, and low-dose trazodone

Trazodone is an antidepressant without GABA activity.

Although the main problems with benzodiazepines and class Z drugs are dependence and the risk of injury, these drugs also have potentially fatal respiratory effects

.

Benzodiazepines inhibit breathing and therefore exacerbate sleep-disordered breathing, which in turn can cause life-threatening arrhythmias

The retrospective cohort study included 400,924 medical insurance beneficiaries over 65 years of age who had no evidence of serious illness or substance use disorder.
From January 2014 to September 2015, they began to study sleep aid treatment
.
The study endpoints are out-of-hospital (primary) and total mortality

.

diagnosis

Test procedure

The results showed that there are currently 32,388 person-years of patients without concurrent opioid use, 260 (8.
0/1,000 person-years) out-of-hospital and 418 (12.
9/1,000) total deaths of benzodiazepines; 26,497 person-years, 150 (5 7/1,000), 227 deaths out of hospital (8.
6/1,000); and 16,177 person-years, 156 (9.
6/1,000) deaths out of hospital, and 256 (15.
8/1,000) total deaths of trazolone
.
In general, there was no difference in the out-of-hospital and total mortality of benzodiazepines (HRs=0.

99; 95%CI: 81-1.

There was no difference in the out-of-hospital and total mortality of benzodiazepines (HRs=0.

Adjusted HR for out-of-hospital and total mortality of benzodiazepines and class Z drugs and trazodone based on concurrent opioid use

Patients who use opioids at the same time currently use 4278 person-years, 90 people (21.

0/1,000) died out of hospital, 127 people (29.

Compared with trazodone, the out-of-hospital and total mortality of benzodiazepines increased by 202% and 121%, respectively (HRs=3.

In summary, if opioids are used at the same time, the use of benzodiazepines and class Z drugs in the elderly is associated with an increase in out-of-hospital and overall mortality

references:

Mortality and concurrent use of opioids and hypnotics in older patients: A retrospective cohort study.
https://doi.
org/10.
1371/journal.
pmed.
1003709

Mortality and concurrent use of opioids and hypnotics in older patients: A retrospective cohort study.
Leave a message here