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Mental & Emotional Health

Anxiety Drug Use Highest in Older Women

Prescription use of benzodiazepines–a widely used class of sedative and anti-anxiety medications–increases steadily with age, despite the known risks for older people, according to a comprehensive analysis of benzodiazepine prescribing in the United States. Popular brand are Valium and Xanax. Given existing guidelines cautioning health providers about benzodiazepine use among older adults, findings from the National Institutes of Health-funded study raise questions about why so many prescriptions–many for long-term use–are being written for this age group. The study was published online in December 2014 in JAMA Psychiatry.

The researchers found that among all adults 18 to 80 years old, about one in 20 received a benzodiazepine prescription in 2008, the period covered by the study. But this fraction rose substantially with age, from 2.6 percent among those 18 to 35 to 8.7 percent in those 65 to 80, the oldest group studied. Long-term use–a supply of the medication for more than 120 days–also increased markedly with age. Of people 65 to 80 who used benzodiazepines, 31.4 percent received prescriptions for long-term use, vs. 14.7 percent of users 18 to 35. In all age groups, women were about twice as likely as men to receive benzodiazepines. Among women 65 to 80 years old, 1 in 10 was prescribed one of these medications, with almost a third of those receiving long-term prescriptions.

A release from NIH quotes Thomas Insel, M.D., director of the National Institute of Mental Health (NIMH), as saying, “These new data reveal worrisome patterns in the prescribing of benzodiazepines for older adults, and women in particular,” This analysis suggests that prescriptions for benzodiazepines in older Americans exceed what research suggests is appropriate and safe.”

Benzodiazepines–named for their chemical structure–are among the most commonly prescribed medications in developed countries. They include alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan). The most common uses of benzodiazepines are to treat anxiety and sleep problems. While effective for both conditions, the medications have risks, especially when used over long periods. Long-term use can lead to dependence and withdrawal symptoms when discontinued. In older people, research has shown that benzodiazepines can impair cognition, mobility, and driving skills, and they increase the risk of falls.

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