A population-based cohort study of anxiety, depression, sleep and alcohol outcomes among benzodiazepine and z-hypnotic users.
OBJECTIVE
The present study aimed to examine anxiety, depression, sleep and alcohol outcomes among individuals who were prescribed benzodiazepines or z-hypnotics in a Norwegian population-based sample (n = 58,967).


METHODS
This 13 year historical cohort study obtained baseline measures of self-report anxiety, depression, sleep difficulties and alcohol use from the Nord-Trøndelag Health Study (HUNT 2, 1995-1997). Information about outcomes was collected from the third wave (HUNT 3, 2006-2008) of the same epidemiological study. Prescription records of benzodiazepines and z-hypnotics were obtained from the Norwegian prescription database (NorPD, 2004-2008) and were linked to the HUNT 2 and HUNT 3 questionnaire data.


RESULTS
Among the 58,967 respondents who were eligible for the study, 13,774 (23%) received at least one prescription of benzodiazepines or z-hypnotics in the period 2004-2008. Benzodiazepine use was associated with a higher risk of severe anxiety, depression and sleep outcomes. The assumption that benzodiazepine use is prospectively associated with a higher risk of problematic alcohol use was not supported.


CONCLUSIONS
Consideration and discussion of the future place of benzodiazepines in treatment of anxiety and sleep difficulties in Norway could be warranted. Benzodiazepines may be efficient in reducing symptoms in the short term, but evidence from this long temporal follow-up study indicates limited positive influences in the long term.
The Drug and Alcohol Treatment Health Trust in Central Norway, Department of Research and Development, Trondheim, Norway. trond.nordfjern@rus-midt.no
Trond
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Nordfjærn
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D001569:Benzodiazepines / Q000009:adverse effects*; D003866:Depressive Disorder / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D057566:Self Report; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D016896:Treatment Outcome; D055815:Young Adult
D006993:Hypnotics and Sedatives; D001569:Benzodiazepines