Chronic use of diazepam in primary healthcare centers

user profile and usage pattern

Authors

  • Carmen Sylvia Ribeiro Universidade Estadual de Campinas
  • Renata Cruz Soares Azevedo Universidade Estadual de Campinas
  • Viviane Franco da Silva Universidade Estadual de Campinas
  • Neury José Botega Universidade Estadual de Campinas

Keywords:

Diazepam, Benzodiazepines, Anti-anxiety agents, Primary health care, Drug prescriptions

Abstract

CONTEXT AND OBJECTIVE: Chronic use of benzodiazepines is frequent in general practice. The aim of this study was to describe the usage pattern and profi le of chronic users of diazepam who had been consuming this drug for a minimum of thirty-six months continuously. DESIGN AND SETTING: This was a descriptive study (survey and clinical assessment) at fi ve primary healthcare centers in Campinas, Brazil. METHODS: Psychotropic drug control books revealed 48 eligible patients. Among these, 41 were assessed by means of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), the Hospital Anxiety and Depression scale (HAD) and a questionnaire on usage pattern. RESULTS: Most patients were women (85.4%). The patients’ mean age was 57.6 years, and they were from the social strata C (39%), D (54%) and E (7%). The mean length of diazepam consumption was 10 years. The patients presented a lack of prescription compliance and had made frustrated attempts to stop using the drug. 55.5% said their doctor had never given any guidance on the effects of the drug. According to SCAN, 25 patients (61%) suffered from depressive disorders; only 12 cases of benzodiazepine dependence were detected by this instrument. CONCLUSION: There is a need to improve the detection and treatment of mental disorders, as well as to prevent inappropriate prescription and use of benzodiazepines. Diazepam dependence has distinctive characteristics that make it undetected by SCAN.

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Author Biographies

Carmen Sylvia Ribeiro, Universidade Estadual de Campinas

MD, MSc. Psychiatrist, Department of Medical Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.

Renata Cruz Soares Azevedo, Universidade Estadual de Campinas

MD, PhD. Psychiatrist and professor, Department of Medical Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.

Viviane Franco da Silva, Universidade Estadual de Campinas

MD, MSc. Psychiatrist, Department of Medical Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.

Neury José Botega, Universidade Estadual de Campinas

MD, PhD. Psychiatrist and professor, Department of Medical Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.

References

Denis C, Fatséas M, Lavie E, Auriacombe M. Pharmacological interventions for benzodiazepine mono-dependence manage- ment in outpatient settings. Cochrane Database Syst Rev. 2006;3:CD005194.

Neutel CI. The epidemiology of long-term benzodiazepine use. Int Rev Psychiatry. 2005;17(3):189-97.

Fritsch Montero R, Rojas Castillo G, Gaete Olivares J, Araya Baltra R, Gonzaléz Rubio I. Benzodiazepine use in Santiago, Chile. Actas Esp Psiquiatr. 2005;33(5):286-91.

Ciuna A, Andretta M, Corbari L, et al. Are we going to increase the use of antidepressants up to that of benzodiazepines? Eur J Clin Pharmacol. 2004;60(9):629-34.

Vedia Urgell C, Bonet Monne S, Forcada Vega C, Parellada Esquius N. Estudio de utilización de psicofármacos en atención primaria. [Study of use of psychiatric drugs in primary care]. Aten Primaria. 2005;36(5):239-45.

Mari JJ, Almeida-Filho N, Coutinho E, Andreoli SB, Miranda CT, Streiner D. The epidemiology of psychotropic use in the city of São Paulo. Psychol Med. 1993;23(2):467-74.

Wortmann AC, Grüdtner MC, Fialho AF, et al. O consumo de benzodiazepina em Porto Alegre. [Benzodiazepine consumption in Porto Alegre]. Rev Ass Med Bras. 1994;40(4):265-70.

Galduróz JC, Noto AR, Nappo SA, Carlini EA. Household survey on drug abuse in Brazil: study involving the 107 major cities of the country--2001. Addict Behav. 2005;30(3):545-56.

Galduróz JC, Noto AR, Carlini EA. IV Levantamento sobre uso de drogas entre estudantes de 1o e 2o graus de 10 capitais brasileiras. São Paulo: Centro Brasileiro de Informações sobre Drogas Psicotrópicas (CEBRID); 1997.

Stewart SA. The effects of benzodiazepines on cognition. J Clin Psychiatry. 2005;66(Suppl 2):9-13.

Laranjeira R, Castro LA. Potencial de abuso de benzodiazepíni- cos. In: Bernik MA, editor. Benzodiazepínicos: quatro décadas de experiência. São Paulo: Edusp; 1999. p. 187-98.

Voyer P, Cappeliez P, Pérodeau G, Préville M. Mental health for older adults and benzodiazepine use. J Community Health Nurs. 2005;22(4):213-29.

Barker MJ, Greenwood KM, Jackson M, Crowe SF. An evaluation of persisting cognitive effects after withdrawal from long-term benzodiazepine use. J Int Neuropsychol Soc. 2005;11(3):281-9.

Barlett G, Abrahamowicz M, Tamblyn R, Grad R, Capek R, du Berger R. Longitudinal patterns of new Benzodiazepine use in the elderly. Pharmacoepidemiol Drug Saf. 2004;13(10):669-82.

Rosenbaum JF. Attitudes toward benzodiazepines over the years. J Clin Psychiatry. 2005;66(Suppl 2):4-8.

Mol AJ, Gorgels WJ, Oude Voshaar RC, et al. Associations of benzodiazepine craving with other clinical variables in a population of general practice patients. Compr Psychiatry. 2005;46(5):353-60.

O’brien CP. Benzodiazepine use, abuse, and dependence. J Clin Psychiatry. 2005;66(Suppl 2):28-33.

Tamblyn R, Abrahamowicz M, du Berger R, McLeod P, Bartlett

G. A 5-year prospective assessment of the risk associated with individual benzodiazepines and doses in new elderly users. J Am Geriatr Soc. 2005;53(2):233-41.

Bélanger L, Morin CM, Bastien C, Ladouceur R. Self-efficacy and compliance with benzodiazepine taper in older adults with chronic insomnia. Health Psychol. 2005;24(3):281-7.

Howard M, Dolovich L, Kaczorowski J, Sellors C, Sellors J. Prescribing of potentially inappropriate medications to elderly people. Fam Pract. 2004;21(3):244-7.

Almeida PM, Wickerhauser H. O critério ABA/ABIPEME: em busca de uma atualização. São Paulo: Associação Brasileira de Anunciantes (ABA)/Associação Brasileira dos Institutos de Pesquisa de Mercado (ABIPEME); 1991.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.

Botega NJ, Bio MR, Zomignani MA, Garcia C, Pereira WA. Transtor- nos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. [Mood disorders among inpatients in ambulatory and validation of the anxiety and depression scale HAD]. Rev Saúde Pública. 1995;29(5):355-63.

WHO. Schedule for Clinical Assessment in Neuropsychiatry, Version

0. New York: US Department of Health and Human Services. Public Health Service Centers for Disease Control; 1998.

Mendonça RT, Carvalho ACD. O papel de mulheres idosas consumidoras de calmantes alopáticos na popularização do uso destes medicamentos. [The role of elderly female consumers of allopathic tranquilizers in the popularization of the use of these medicines]. Rev Latinoam Enfermagem. 2005;13(2, n. esp):1207-12.

Horta BL, de Lima MS, Faleiros JJ, Weiderpass E, Horta RL. Benzodiazepínicos: estudo de prescrição em um posto de atenção primária à saúde. [Benzodiazepinics: prescription study in a primary health care unit]. Rev Assoc Med Bras. 1994;40(4):262-4.

van Rijswijk E, Zandstra SM, van de Lisdonk EH, Zitman FG, van Weel C. Appropriateness of benzodiazepine prescribing in general practice. Int J Clin Pharmacol Ther. 2005;43(8):411-2.

Haydon E, Rehm J, Fisher B, Monga N, Adlaf E. Prescrip- tion drug abuse in Canada and the diversion of prescription drugs into the illicit drug market. Can J Public Health. 2005;96(6):459-61.

Voyer P, McCubbin M, Cohen D, Lauzon S, Collin J, Boivin C. Unconventional indicators of drug dependence among elderly long-term users of benzodiazepines. Issues Ment Health Nurs. 2004;25(6):603-28.

Stevens JC, Pollack MH. Benzodiazepines in clinical practice: consideration of their long-term use and alternative agents. J Clin Psychiatry. 2005;66(Suppl 2):21-7.

Morgan JD, Wright DJ, Chrystyn H. Pharmacoeconomic evaluation of a patient education letter aimed at reducing long-term prescribing of benzodiazepines. Pharm World Sci. 2002;24(6):231-5.

Gask L, Dixon C, May C, Dowrick C. Qualitative study of an educational intervention for GPs in the assessment and manage- ment of depression. Br J Gen Pract. 2005;55(520):854-9.

Kan CC, Hilberink SR, Breteler MH. Determination of the main risk factors for benzodiazepine dependence using a mul- tivariate and multidimensional approach. Compr Psychiatry. 2004;45(2):88-94.

Auchewski L, Andreatini R, Galduróz JC, de Lacerda RB. Avaliação da orientação médica sobre os efeitos colaterais de benzodiazepíni- cos. [Evaluation of the medical orientation for the benzodiazepine side effects]. Rev Bras Psiquiatr. 2004;26(1):24-31.

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Published

2007-09-09

How to Cite

1.
Ribeiro CS, Azevedo RCS, Silva VF da, Botega NJ. Chronic use of diazepam in primary healthcare centers: user profile and usage pattern. Sao Paulo Med J [Internet]. 2007 Sep. 9 [cited 2025 Oct. 16];125(5):270-4. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2164

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Original Article