Although there was a slight downward trend within the prescription of benzodiazepines (depressants that relieve anxiety, muscle spasms, produce sedation and reduce seizures) amongst older people over the past decade, the proportion of individuals first prescribed these drugs after the onset of coronary artery disease ( From studies published today in: stroke brought on by blood clots) continues to be serious Impacta peer-reviewed scientific journal of the American Stroke Association, a division of the American Heart Association.

After a stroke, benzodiazepines could also be used to calm anxiety and improve sleep. Nonetheless, when prescribed to older people, these medications can increase the chance of falls and bone fractures, in addition to memory problems, confusion, and other harmful effects. The U.S. Drug Enforcement Administration has listed benzodiazepines as a Schedule IV substance which will cause abuse, addiction, withdrawal and illegal distribution.

Researchers reviewed U.S. Medicare claims data and analyzed the primary 10 years of first-time benzodiazepine prescribing amongst greater than 120,000 people aged 65 and older hospitalized with ischemic stroke. We examined the speed of benzodiazepine prescriptions in the primary three months after stroke, and the information were adjusted for race, gender, and ethnicity. Prescribing patterns were then reviewed from yr to yr to find out the number of doubtless excessive latest benzodiazepine prescriptions given to stroke survivors.

We reviewed stroke survivors 90 days after stroke because this era is crucial for rehabilitation of motor, speech and cognitive functions, in addition to mental health. This is commonly a really difficult time for patients who experience a lack of mobility and independence. Benzodiazepines could make recovery and rehabilitation tougher. For this older age group, guidelines recommend that prescribing benzodiazepines needs to be avoided every time possible. Nonetheless, there could also be cases where benzodiazepines are prescribed and needs to be used as needed. For instance, to treat breakthrough anxiety, a physician may prescribe some pills and advise the patient that the medication should only be used when needed. The increased risk of addiction, falls and other harmful effects needs to be discussed with the patient.”

Julianne Brooks, MPH, study co-author, director of knowledge science, Center for Value-Based Health Care and Learning at Massachusetts General Brigham, Boston

The study showed:

• Inside 90 days of stroke, 6,127 (4.9%) people initiated benzodiazepine treatment for the primary time.
• Essentially the most ceaselessly prescribed benzodiazepines were lorazepam (40%) and alprazolam (33%).
• Three-quarters of first-time benzodiazepine prescriptions were for greater than seven days’ supplies, and greater than half were for 15- to 30-day supplies.
• Prescription rates were higher amongst women (5.5%) than men (3.8%).
• Prescription fill rates were also higher for Latino adults (5.8%), although this group was limited by the small variety of participants at 1.9% of the entire sample.
• Overall, the very best prescription rate was within the Southeast (5.1%) and the bottom within the Midwest (4%) of america. “The southeastern region is a stroke belt with higher rates of stroke, which can explain a few of the differences in care on this region,” Brooks said.
• Overall, from 2013 to 2021, there was a moderate 1.6% decline in primary prescriptions across the country.

“We found a pattern of potential oversupply of those initial benzodiazepine prescriptions that may be enough to cause patients to take them long-term or possibly grow to be addicted. Benzodiazepine prescriptions disbursed in these circumstances can result in addiction, Brooks said. “Greater awareness and improved recommendations in regards to the risks of those drugs are needed for older stroke survivors.

“Although overall prescribing rates have fallen barely over 10 years, this prescribing pattern stays an issue. That is concerning because older adults are vulnerable to overprescription and adversarial effects. We all know from previous research that vulnerable and marginalized populations have poorer outcomes after stroke, so we would like to know the aspects which may be playing a job so we are able to provide higher care,” Brooks said.

The American Geriatrics Society’s 2019 Beers Criteria provides a listing of medicines that health care providers can use to securely prescribe medications to adults over 65 years of age. The Beers Criteria recommends avoidance of benzodiazepines in all older adults attributable to the chance of cognitive impairment, delirium, falls and fractures, and motorized vehicle accidents.

“Other guidelines also suggest behavioral interventions, resembling cognitive behavioral therapy for insomnia, antidepressants for anxiety disorders, and trying nonpharmaceutical interventions first,” Brooks said.

The researchers said more research is required to know whether there may be a protected level of prescribing of benzodiazepines which may be most appropriate for older people. The important limitation was that the study used a big, nationwide dataset that didn’t include information on why benzodiazepines were prescribed.

Stroke is the leading reason for serious long-term disability within the U.S. and accounted for roughly 1 in 21 deaths in america in 2021, in response to the American Heart Association’s 2024 update of heart disease and stroke statistics.

Study details, background and design:

• The evaluation included data on 126,050 adults covered by U.S. Medicare, including all adults aged 65 and older discharged from hospital with ischemic stroke between 2013 and 2021.
• Their average age was 78 years; 54% identified as women and 82% identified as white adults.
• The evaluation examined latest benzodiazepine prescriptions inside 90 days of discharge after ischemic stroke. Only individuals who had not previously been prescribed benzodiazepines were included within the study.