Do not prescribe benzodiazepines and Serotonergic Antidepressants (SSRIs) after an acute cardiovascular event without planning for a follow-up review.

Do not prescribe benzodiazepines and Serotonergic Antidepressants (SSRIs) after an acute cardiovascular event without planning for a follow-up review.

Type of practice

Drugs

Age

Adult, Geriatric

Topic Area

Cardiology

Benzodiazepines (BDZ) are the most prescribed drugs in Western countries and up to 30% of patients prescribed it during hospitalization continue to take it at 12 months. BDZs are associated with a 5-fold increase in cognitive impairment, psychomotor impairment, and are associated with more accidents and falls, particularly in elderly patients. In addition, BDZs can cause short-term confusion and delirium in the latter, so they should be avoided. Finally, in the long term, the use of BDZs like Serotonergic Antidepressants (SSRIs) leads to tolerance and dependence. Anyone who prescribes these drugs in the acute phase must comply with a principle of caution by limiting their use to cases of real need, for definite periods of time, discouraging their chronic use and abuse.

Sources

1. Srisurapanont M. et al. Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand. BMC Fam Pract. 2005;6:27.
2. 2019 American Geriatric Society Beers Criteria for Potentially Inappropriate Medication in use in Older Adult.. https://geriatricsareonline.org/toc/american-geriatrics-society-updated-beers-criteria/CL001
3. Choosing Wisely. Insomnia and anxiety in older people. https://www.choosingwisely.org/wp-content/uploads/2018/02/Treating-Insommina-And-Anxiety-In-Older-People-AGS.pdf
4. Brandt J et al. Benzodiazepines and Z-drugs: an updated review of major adverse outcomes reported on in epidemiologic research. Drugs RD 2017;493-507
5. Fava G.A. et al. Withdrawal Symptoms after Selective Serotonin Reutake Inhibitor Discontinuation: A Systematic Review. Psychoter Psychosom 2015;84:72-81.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.