Nav: Home

Benzodiazepines in patients with COPD and PTSD may increase suicide risk

October 12, 2018

Oct. 12, 2018--Long-term use of benzodiazepine medications in patients with chronic obstructive pulmonary disease, or COPD, as well as posttraumatic stress disorder (PTSD) may lead to increased suicide risk, according to a study published online in the Annals of the American Thoracic Society.

In "Risks of Benzodiazepines in Chronic Obstructive Pulmonary Disease with Comorbid Posttraumatic Stress Disorder," Lucas M. Donovan, MD, and coauthors report on a study of 44,555 veterans who received medical care between 2010-12. Of these, 23.6 percent received benzodiazepines long term (90 days or longer).

Benzodiazepines are commonly prescribed for COPD symptoms, including anxiety, shortness of breath and insomnia. They are also commonly prescribed to those with PTSD to treat anxiety and insomnia.

Their use for both patient groups is controversial because of adverse side effects, including an increased risk of COPD exacerbations and self-injury. Many guidelines specifically recommend against their use for patients with COPD or PTSD.

"The use of benzodiazepines among patients with high-risk comorbidities is a frequent dilemma for patients and clinicians," said Dr. Donovan, a pulmonary, critical care and sleep physician and health services researcher at the VA Puget Sound Healthcare System. "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."

To better understand the risks posed by benzodiazepines, and not just the symptoms they treat, the researchers matched patients in their analysis by taking over 44 patient characteristics into account. These characteristics included medical and psychiatric history, medication use and health care utilization. .

The researchers found that long-term use of benzodiazepines in COPD patients who also had PTSD more than doubled their risk of suicide. These patients also had higher rates of psychiatric admissions.

Interestingly, the researchers did not find that long-term use of benzodiazepines in this patient group increased their risk of death from all causes or respiratory events, as previous studies have suggested.

The researchers did find that short-term use (less than 90 days) of benzodiazepines was associated with increased mortality, which supports previous findings. Dr. Donovan said this finding should be interpreted with some caution given the researchers did not use the same matching techniques employed in the primary analyses.

The authors said study limitations include the possibility of not being able to fully determine the severity of lung obstruction or PTSD from medical record data.

"Although long-term benzodiazepine use among patients with COPD and PTSD is not linked with overall mortality, the association with suicide is concerning," said Dr. Donovan, who is also an acting instructor at the University of Washington. "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."
-end-
Follow Us

ATS - @atscommunity

AnnalsATS - @AnnalsATSEditor

About the Annals of the American Thoracic Society (AnnalsATS)

The AnnalsATS is a peer-reviewed journal published by the American Thoracic Society. The Journal delivers up-to-date and authoritative coverage of adult and pediatric pulmonary and respiratory sleep medicine and adult critical care. The scope of the Journal encompasses content that is applicable to clinical practice, the formative and continuing education of clinical specialists and the advancement of public health. Editor: David Lederer, MD, MS, associate professor of medicine and epidemiology and associate division chief for clinical and translational research at Columbia University.

About the American Thoracic Society

Founded in 1905, the American Thoracic Society is the world's leading medical association dedicated to advancing pulmonary, critical care and sleep medicine. The Society's 15,000 members prevent and fight respiratory disease around the globe through research, education, patient care and advocacy. The ATS publishes three journals, the American Journal of Respiratory and Critical Care Medicine, the American Journal of Respiratory Cell and Molecular Biology and the Annals of the American Thoracic Society.

The ATS will hold its 2019 International Conference, May 17-22, in Dallas, Texas, where world-renowned experts will share the latest scientific research and clinical advances in pulmonary, critical care and sleep medicine.

American Thoracic Society

Related Suicide Articles:

Does religion protect against suicide?
Religious participation is linked to lower suicide rates in many parts of the world, including the United States and Russia, but does not protect against the risk of suicide in sections of Europe and Asia, finds new research by a Michigan State University scholar.
Children at increased risk of suicide
Teenagers injured through drinking, drug abuse or self-harming have a five-fold increased risk of dying from suicide in the next decade.
Young cancer survivors have twice the risk of suicide
Survivors of cancer diagnosed before the age of 25 had a more than two-fold increased risk of suicide compared to their non-cancer peers.
Suicide prevention: Reacting to the tell-tale signs
Can search engines save lives? Ludwig-Maximilians-Universitaet (LMU) in Munich researchers are working on an approach which would enable search engines to more effectively identify users who are at risk of suicide and provide them with information on where to find help.
Canada needs a national suicide prevention strategy
Canada needs a national suicide prevention strategy, and it should be included in the 2017 federal budget, argues an editorial in CMAJ (Canadian Medical Association Journal).
How to reduce US firearm suicide rates?
Reducing firearm access, smart gun technology, and public education could reduce firearm suicides in the United States, finds a new report from Columbia University and New York State Psychiatric Institute.
Arthritis linked to suicide attempts
One in every 26 men with arthritis have attempted suicide compared to one in 50 men without arthritis.
Two in 5 individuals with schizophrenia have attempted suicide
A new study by the University of Toronto (U of T), released today, found that those with schizophrenia who'd been physically abused during childhood were five times more likely to have attempted suicide.
Victimized adolescents more at risk of thinking about suicide or attempting suicide at 15
A study to be published in the February 2016 issue of the Journal of the American Academy of Child and Adolescent Psychiatry reports that adolescents chronically victimized during at least two school years, are about five times more at risk of thinking about suicide and six times more at risk of attempting suicide at 15 years compared to those who were never victimized.
1 in 10 suicide attempt risk among friends and relatives of people who die by suicide
People bereaved by the sudden death of a friend or family member are 65 percent more likely to attempt suicide if the deceased died by suicide than if they died by natural causes.

Related Suicide Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#529 Do You Really Want to Find Out Who's Your Daddy?
At least some of you by now have probably spit into a tube and mailed it off to find out who your closest relatives are, where you might be from, and what terrible diseases might await you. But what exactly did you find out? And what did you give away? In this live panel at Awesome Con we bring in science writer Tina Saey to talk about all her DNA testing, and bioethicist Debra Mathews, to determine whether Tina should have done it at all. Related links: What FamilyTreeDNA sharing genetic data with police means for you Crime solvers embraced...