Tolerance to benzodiazepines among long-term users in primary care

• Published in: Family practice Vol. 30; no. 4; pp. 404 - 410
• Main Authors: Willems, Inge A T, Gorgels, Wim J M J, Oude Voshaar, Richard C, Mulder, Jan, Lucassen, Peter L B J
• Format: Journal Article
• Language: English
• Published: England 01.08.2013
• Subjects: Adult; Anti-Anxiety Agents - classification; Anti-Anxiety Agents - pharmacology; Anxiety Disorders - drug therapy; Benzodiazepines; Benzodiazepines - classification; Benzodiazepines - pharmacology; Dosage; Dose-Response Relationship, Drug; Drug Tolerance; Female; General practice; Humans; Male; Middle Aged; Netherlands; Practice Patterns, Physicians' - statistics & numerical data; Prescribed; Primary health care; Primary Health Care - methods; Primary Health Care - statistics & numerical data; Sleep Wake Disorders - drug therapy; Substance-Related Disorders - epidemiology; Substance-Related Disorders - etiology; Time; Tolerance; Netherlands; Anxiety/anxiety; clinical; disorder; sleep disorders; substance; primary care; psychiatry; abuse (not tobacco); longitudinal; research
• ISSN: 0263-2136; 1460-2229
• DOI: 10.1093/fampra/cmt010

Tolerance towards the effects of benzodiazepines is observed in various animal and human studies. Therefore, it is assumed that patients who use benzodiazepines for a longer period of time need to increase their dose over time to experience the same effect. To observe whether long-term benzodiazepine users increase their dose over time. From the Dutch National Information Network of Family Practices, a group of long-term benzodiazepine users was identified. This group was divided into an incident long-term benzodiazepine users group (N = 113) and a prevalent long-term benzodiazepine users group (N = 992). Long-term use of benzodiazepines was defined as usage for at least 6 months. The main outcome was a change in prescribed dose from baseline until 24 months after baseline. Linear regression analysis was performed to evaluate dose change. Neither incident long-term benzodiazepine users nor prevalent long-term benzodiazepine users were prescribed increasing dosages during follow-up. There is no increase in prescribed dose among long-term users, as might be expected due to the development of tolerance to the effects of benzodiazepines.