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Long-Term Benzodiazepine Use May Increase Suicide Risk Among Veterans
Long-term use of benzodiazepines in patients with chronic obstructive pulmonary disease (COPD) and posttraumatic stress disorder (PTSD) is associated with an increased risk for suicide, according to results of a new study.
The new study, published by the American Thoracic Society, shows that the suicide risk doubles for COPD patients with PTSD who have used benzodiazepines for more than 90 days. The same patients also have higher rates of psychiatric admissions.
The use of benzodiazepine medications in both groups has been controversial due to their known potential adverse effects, such as increased risk for COPD exacerbations, with many guidelines recommending against their use among patients with COPD or PTSD.
The link between benzodiazepine and increased suicide risk was identified after the researchers reviewed the records of 44,555 veterans who had received medical care between 2010 and 2012. Of these, 23.6% had received benzodiazepines in the long term.
“Understanding the risks of benzodiazepines is difficult because the symptoms that prompt their use, including anxiety and shortness of breath, are themselves linked with poor outcomes,” said study coauthor Lucas M. Donovan, MD, who is a pulmonary, critical care, and sleep physician and health services researcher at the VA Puget Sound Healthcare System.
To account for this, the researchers looked at more than 44 patient characteristics when gathering evidence.
While long-term use had a negative effect on suicide risk, the researchers did not see an increased risk of death from all causes or respiratory events, as previous studies had suggested. But as earlier findings had shown, short-term use (fewer than 90 days) of benzodiazepines was associated with increased mortality.
“Although long-term benzodiazepine use among patients with COPD and PTSD is not linked with overall mortality, the association with suicide is concerning,” Donovan said. “More research will be needed to better understand this link with suicide, but in the meantime, we would advise that clinicians reconsider prescribing benzodiazepines to patients who already are at high risk for self-harm.”2
—Colleen Murphy
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