College of Pharmacy
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HelixTalk Episode #68 - Hooked on a feeling: how to discuss benzodiazepine tapers with your patients
Date posted: October 17, 2017, 6:00 am
In this episode, we will discuss the current state of benzodiazepine use, expected trends in prescribing, and risks associated with use. Lastly, we will discuss techniques for ensuring that a benzodiazepine taper is performed in a safe manner with lowest risk of harm.
- Benzodiazepine use has been clearly associated with risk of falls, altered mental status, impaired cognition, dependence, and interference with psychotherapy.
- At the same time, there are social and cultural underpinnings which result in some individuals using these medications for decades, leading to (justified) hesitancy to consider discontinuation.
- Dosing tapers need to be designed on a patient specific basis, in terms of length of taper and agent used.
- Ensure that alternate treatment strategies are used to address any emergent or underlying anxiety, with ideal focus on non-pharmacologic methods such as Cognitive Behavioral Therapy.
- VA Academic Detailing Service. Re-evaluating the use of benzodiazepines: A VA clinician’s guide. 2016. Available: https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/Academic_Detailing_Educational_Material_Catalog/22_Benzodiazepine_Provider_AD_Educational_Guide_IB_10_928.pdf. Accessed 9/29/17.
- Tannenbaum C,Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education. The EMPOWER cluster randomized trial. JAMA Intern Med. 2014;174(6):890-898.