Are Stroke Survivors Getting Too Many Sedatives Like Xanax, Valium?

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Doctors might be overprescribing sedatives to stroke survivors, a new study warns.

About 5% of people are prescribed a benzodiazepine following a stroke, to help calm anxiety and improve sleep, researchers found. Benzodiazepine meds include Valium, Ativan and Xanax.

But these prescriptions often are for pills that last longer than a week, which could hamper a person’s recovery and increase their risk of addiction.

“We found a pattern of potential oversupply with these initial benzodiazepine prescriptions, which would be enough for patients to become long-term users or possibly addicted,” said researcher Julianne Brooks, a data analytics manager at Massachusetts General Brigham in Boston. “The benzodiazepine prescriptions given under these circumstances may lead to dependence.”

For the study, researchers analyzed a decade’s worth of Medicare claims data on first-time prescriptions for benzodiazepines among more than 120,000 stroke victims aged 65 and older.

“For this older age group, guidelines recommend that benzodiazepine prescriptions should be avoided if possible,” Brooks said.

These sedatives increase the risk of falls, broken bones, memory problems, confusion and other harmful effects, the researchers said.

“However, there may be cases where benzodiazepines are prescribed to be used as needed,” Brooks noted. “For example, to treat breakthrough anxiety, a provider may prescribe a few pills and counsel the patient that the medication should only be used as needed.”

Researchers found that about 5% of patients were started on a benzodiazepine within 90 days of their stroke.

Lorazepam (Ativan) and alprazolam (Xanax) were most frequently prescribed, to 40% and 33% of patients, respectively.

Three-quarters of these prescriptions were for a supply of over seven days, and more than half for a supply between 15 and 30 days, researchers found.

That’s too many pills, researchers contend.

“Benzodiazepines may inhibit recovery and rehabilitation,” Brooks said.

“Although the overall prescription rate decreased slightly over 10 years, this prescription pattern is still a problem,” Brooks added. “It’s concerning because older adults are vulnerable to overprescribing and adverse outcomes.”

Prescription rates were higher among women (5.5%) than men (3.8%).

Overall, prescription rates were highest in the Southeast (5.1%) and lowest in the Midwest (4%).

“The Southeast region is the stroke belt with a higher rate of strokes, so that could explain some differences in care in that region,” Brooks said.

The findings were published Oct. 17 in the journal Stroke.

The American Geriatrics Society recommends avoiding benzodiazepines in all older adults due to the risk of cognitive impairment, delirium, falls, fractures and motor vehicle crashes, the researchers noted.

“Other guidelines also suggest behavioral interventions such as cognitive behavior therapy for insomnia, antidepressant medications for anxiety disorders and trying non-pharmaceutical interventions first,” Brooks said in a journal news release.

However, the researchers said more studies are needed to figure out if there is a safe level for prescribing benzodiazepines to seniors.

More information

The U.S. Centers for Disease Control and Prevention has more on stroke treatment.

SOURCE: American Heart Association, news release, Oct. 17, 2024

Source: HealthDay

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