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- Title
Uso inapropiado de fármacos de prescripción: dependencia a benzodiazepinas en adultos mayores.
- Authors
Minaya, Omar; Ugalde, Oscar; Fresán, Ana
- Abstract
Misuse and potential abuse of prescription drugs are growing problems in elderly people over 65 years old. Although the prevalence of this condition is difficult to estimate, drug misuse is most common in elderly women. A great proportion of the psychoactive prescriptions in old people include tranquilizers and hypnotics. There are several risk factors related to increased risk misuse, abuse, and dependence of prescription drugs. The following are among these risk factors: the female gender, social isolation, history of substance abuse or dependence, history of mental illness and medical exposure to prescription drugs with abuse potential. Also, BDZ consumption for a period longer than four weeks has also been associated to BDZ dependence, even at therapeutic doses. Until now, BDZ dependence in the elderly has been poorly studied, so the present study may increase our knowledge of this complex phenomenon. Objective The aim of the present study was to describe and compare sociodemographic and clinical features related to the prescription and benzodiazepines use in old people with and without dependence to these drugs in an outpatients psychogeriatric service. Method A total of 39 patients from the outpatients service at the psychogeriatric clinic of the National Institute of Psychiatry Ramón de la Fuente in Mexico City were recruited. All of the participants signed an informed consent to be included in the study. Several assessments were performed to determine the psychopathological status. Diagnosis of BDZ dependence was obtained with the SCID-I Interview, the severity of depression and anxiety symptoms were evaluated through the Montgomery & Asberg Scale (MADRS) and the Hamilton Anxiety Scale, respectively. For the evaluation of the functionality level, the Katz Index and GAF were used. Results No significant differences were found between patients with and without BDZ dependence in terms of social and demographic characteristics and medical comorbidity. The main Axis I diagnoses of the patients were depressive disorder or anxiety disorders. The first medical prescription of BDZ in patients with BDZ dependence was the presence of anxiety symptoms, while for patients without BDZ dependence the aim of BDZ prescription was the treatment of insomnia. The mean age of BDZ use onset and the time of consumption were 57.5 years and 675.2 weeks, respectively. The average dose of BDZ used by the patients was 14.4mg of diazepam equivalents. Significant differences were found between groups in terms of BDZ consumption features. Patients with BDZ dependence exhibited more drug seeking behavior, more abandonment of daily activities, and more tolerance and abstinence symptoms. Patients with BDZ dependence exhibited more prominent symptoms of anxiety and depression than patients without BDZ dependence. Also, these patients had a poorer cognitive performance and lower psychosocial functioning. Discussion BDZ dependence is a complex phenomenon related to the severity of depressive and anxiety symptoms.…
- Subjects
MEXICO City (Mexico); MEXICO; MEDICATION abuse; BENZODIAZEPINE abuse; BICYCLIC diazepines; MENTAL depression risk factors; MENTAL health
- Publication
Salud Mental, 2009, Vol 32, Issue 5, p405
- ISSN
0185-3325
- Publication type
Article