Benzodiazepine Could Put COPD, PTSD Patients at Increased Suicide Risk

Long-term benzodiazepine use may heighten the risk of suicide among chronic obstructive pulmonary disease (COPD) and posttraumatic stress disorder (PTSD) patients according to a recent study.

Researchers evaluated data from the Veteran’s Health Administration on 44,555 patients with COPD and PTSD between 2010 and 2012. Of the eligible patients, 23.6% received benzodiazepines long-term (≥ 90 days). The benzodiazepine group was matched with a control group of 19,552 patients.

There were no differences in mortality between the groups (hazard ratio [HR] for long-term use 1.06, 95% CI 0.95-1.18), but the long-term benzodiazepine group was more than twice as likely to die by suicide (HR 2.33, 95% CI 1.14-4.79). Short-term, but not long-term, benzodiazepine use in all patients was associated with a slight increase in mortality (short-term: HR 1.16, 95% CI 1.05-1.28; long-term: HR 1.03, 95% CI 0.94-1.13).

Study author Lucas M. Donovan, MD, a pulmonary, critical care and sleep physician and health services researcher at the VA Puget Sound Healthcare System, said other risks associated with benzodiazepine have been previously documented.

“The use of benzodiazepines among patients with high-risk comorbidities is a frequent dilemma for patients and clinicians,” said Donovan. “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.”

While long-term use does not directly increase mortality, Donovan called the link between benzodiazepines and suicide “concerning.”

“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,” said Donovan.

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Sources: Annals of the American Thoracic Society, EurekAlert