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Dr Gérald Kierzek (Medical Director of Doctissimo)
According to the results of a study, the use of benzodiazepines has increased in China. The use of this treatment should be avoided as much as possible, especially in the elderly. The explanations of Dr Gérald Kierzek, emergency doctor and medical director of Doctissimo.
Often used to treat sleep problems, benzodiazepines are drugs that have various adverse effects, particularly increased in the elderly. This is why scientific studies are regularly carried out to regularly assess their consumption.
A boom in benzodiazepine use in China
In a study published on February 17, Chinese researchers examined data from more than 550,000 adult insomnia outpatient visits performed at primary health care facilities in Beijing between 2016 and 2020. Results: They found that the overall rate of benzodiazepine prescriptions increased from 34.8% to 62.8% over the study period, with the greatest increases occurring in elderly patients.
Significant consumption in France too
In France, the consumption of benzodiazepines is also high, particularly among people over 65, 30% of whom take these drugs. Lexomil ®, Xanax ®, Témesta ®, Tranxène ® or even Stilnox ® are therefore consumed regularly, whereas their use should only be occasional.
These drugs, although effective in treating insomnia, have a number of adverse effects, including the risk of addiction. In addition, in the elderly, taking benzodiazepines is associated with increased risks of car accidents, falls and fractures, hospitalization and ultimately death. Several studies have also linked their long-term use to an increased risk of Alzheimer’s disease.
Assess addiction to initiate withdrawal
To reduce this consumption, the ANSM recalls that prescription should only be considered after the failure of medicinal approaches and that it must “be as short as possible“, 4 weeks maximum for hypnotics (sleeping pills) and 12 weeks for anxiolytics.
The High Authority of Health (HAS) has calculated the prescription duration of sleeping pills at 7 months on average. To limit the risk of addiction to these drugs, it issues certain recommendations for doctors. Objective : “assess the patient’s dependence on the treatment and his degree of attachment to these products to decide with him on a strategy adapted to his situation”.
HAS also provides doctors with a special card. Thus, during a dedicated consultation, the doctor must carry out this assessment based on this document and set up a withdrawal protocol if necessary, with the patient’s agreement.
The opinion of Dr Gérald Kierzek, emergency doctor and medical director of Doctissimo
“For the elderly, the very fact of being old is a risk factor in taking benzodiazepines, because the pharmacodynamics of the body is slowed down, which makes the elimination of the molecule in the body slower. In addition to this, there is a greater risk of drug interaction, undernutrition, weight loss and an increased sedative effect, which increases the risk of falls“says the doctor.
“These molecules must be prescribed for a maximum of eight to twelve weeks, counting withdrawal, ideally only a few days, with the lowest possible dosage.” he adds. “Thereafter, each patient must be considered according to his or her case: the cause of insomnia must be sought and the cause treated by cognitive-behavioral therapies for example”.