For Older COPD Patients, Common Meds Pose a Risk

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A group of drugs commonly prescribed for insomnia, anxiety, and breathing issues "significantly increase the risk" that older people with chronic obstructive pulmonary disease (COPD), also known as emphysema, need to visit a doctor or Emergency Department for respiratory reasons. That is the finding of research done at St. Michael's Hospital in Toronto and published online on april 17^th 2014 in the European Respiratory Journal. 

A release from the hospital explains that benzodiazepines such as Ativan or Xanax may actually contribute to respiratory problems for aging COPD patients by depressing the ability breathe and making the sufferers more prone to pneumonia.

Dr. Nicholas Vozoris said the findings are significant, given that 5 to 10 per cent of the Canadian population has COPD, which is mainly caused by smoking. His previous research has shown that 30 per cent of older Canadians with COPD are prescribed benzodiazepines. The release did not provide statistics for the US but the American Lung Association reports that the condition is the third leading cause of death in this country. The Centers for Disease control notes that of the estimated 4.7 million Americans ever diagnosed with emphysema, 92 percent are 45 or older.

Dr. Vozoris said he believes this is the first study to look at clinical outcomes of COPD patients prescribed these drugs. He used databases at the Institute for Clinical Evaluative Studies to identify older adults in Ontario who had been diagnosed with COPD, as well as prescription, health insurance, and hospitalization records.

He found that COPD patients who had been newly prescribed a benzodiazepine were at 45 per cent increased risk of having an exacerbation of respiratory symptoms requiring outpatient treatment. They were at 92 per cent greater risk of needing to visit an Emergency Department for COPD or pneumonia. There was an elevated, but not statistically significant, risk of also being hospitalized for respiratory reasons.

He said the findings were consistent even after taking into account the severity of the person's illness. They were true for people with less advanced and more advanced COPD.

"Physicians, when prescribing these pills, need to be careful, use caution and monitor the patients for respiratory side effects," said Dr. Vozoris. "Patients also need to watch for respiratory-related symptoms."