Use of benzodiazepines and benzodiazepine‐related drugs in the Nordic countries between 2000 and 2020

Use of benzodiazepines (BZ) and related drugs is subject to considerable debate due to problems with dependency and adverse events. We aimed to describe and compare their use across the Nordic countries. Data on the use of clonazepam, BZ‐sedatives, BZ‐hypnotics, and benzodiazepine‐related drugs (BZR...

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Published inBasic & clinical pharmacology & toxicology Vol. 132; no. 1; pp. 60 - 70
Main Authors Højlund, Mikkel, Gudmundsson, Larus S., Andersen, Jacob H., Saastamoinen, Leena K., Zoega, Helga, Skurtveit, Svetlana O., Wastesson, Jonas W., Hallas, Jesper, Pottegård, Anton
Format Journal Article
LanguageEnglish
Published England Wiley Subscription Services, Inc 01.01.2023
John Wiley and Sons Inc
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Online AccessGet full text
ISSN1742-7835
1742-7843
1742-7843
DOI10.1111/bcpt.13811

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Abstract Use of benzodiazepines (BZ) and related drugs is subject to considerable debate due to problems with dependency and adverse events. We aimed to describe and compare their use across the Nordic countries. Data on the use of clonazepam, BZ‐sedatives, BZ‐hypnotics, and benzodiazepine‐related drugs (BZRD) in adults (≥20 years) were obtained from nationwide registers in Denmark, Finland, Iceland, Norway, and Sweden, 2000–2020. Main measures were therapeutic intensity (TI:DDD/1000 inhabitants [inhab.]/day) and annual prevalence (users/1000 inhab./year). Overall, TI of BZ and related drugs decreased in all Nordic countries from 2004 to 2020. However, there were considerable differences between countries in TI. In 2020, the TI of BZ and related drugs ranged from 17 DDD/1000 inhab./day in Denmark to 93 DDD/1000 inhab./day in Iceland. BZRD accounted for 55–78% of BZ use in 2020, followed by BZ sedatives at 20–44%, BZ‐hypnotics at <1–5%, and clonazepam at <1–2%. Annual prevalence of BZ use increased with age in all countries, and the highest annual prevalence was observed among people ≥80 years. Overall, the use of BZ and related drugs has decreased in all Nordic countries from 2004 to 2020, however, with considerable differences in their use between countries. The highest prevalence was observed among the oldest age groups—despite warnings against their use in this population.
AbstractList Use of benzodiazepines (BZ) and related drugs is subject to considerable debate due to problems with dependency and adverse events. We aimed to describe and compare their use across the Nordic countries. Data on the use of clonazepam, BZ‐sedatives, BZ‐hypnotics, and benzodiazepine‐related drugs (BZRD) in adults (≥20 years) were obtained from nationwide registers in Denmark, Finland, Iceland, Norway, and Sweden, 2000–2020. Main measures were therapeutic intensity (TI:DDD/1000 inhabitants [inhab.]/day) and annual prevalence (users/1000 inhab./year). Overall, TI of BZ and related drugs decreased in all Nordic countries from 2004 to 2020. However, there were considerable differences between countries in TI. In 2020, the TI of BZ and related drugs ranged from 17 DDD/1000 inhab./day in Denmark to 93 DDD/1000 inhab./day in Iceland. BZRD accounted for 55–78% of BZ use in 2020, followed by BZ sedatives at 20–44%, BZ‐hypnotics at <1–5%, and clonazepam at <1–2%. Annual prevalence of BZ use increased with age in all countries, and the highest annual prevalence was observed among people ≥80 years. Overall, the use of BZ and related drugs has decreased in all Nordic countries from 2004 to 2020, however, with considerable differences in their use between countries. The highest prevalence was observed among the oldest age groups—despite warnings against their use in this population.
Use of benzodiazepines (BZ) and related drugs is subject to considerable debate due to problems with dependency and adverse events. We aimed to describe and compare their use across the Nordic countries. Data on the use of clonazepam, BZ-sedatives, BZ-hypnotics, and benzodiazepine-related drugs (BZRD) in adults (≥20 years) were obtained from nationwide registers in Denmark, Finland, Iceland, Norway, and Sweden, 2000-2020. Main measures were therapeutic intensity (TI:DDD/1000 inhabitants [inhab.]/day) and annual prevalence (users/1000 inhab./year). Overall, TI of BZ and related drugs decreased in all Nordic countries from 2004 to 2020. However, there were considerable differences between countries in TI. In 2020, the TI of BZ and related drugs ranged from 17 DDD/1000 inhab./day in Denmark to 93 DDD/1000 inhab./day in Iceland. BZRD accounted for 55-78% of BZ use in 2020, followed by BZ sedatives at 20-44%, BZ-hypnotics at <1-5%, and clonazepam at <1-2%. Annual prevalence of BZ use increased with age in all countries, and the highest annual prevalence was observed among people ≥80 years. Overall, the use of BZ and related drugs has decreased in all Nordic countries from 2004 to 2020, however, with considerable differences in their use between countries. The highest prevalence was observed among the oldest age groups-despite warnings against their use in this population.Use of benzodiazepines (BZ) and related drugs is subject to considerable debate due to problems with dependency and adverse events. We aimed to describe and compare their use across the Nordic countries. Data on the use of clonazepam, BZ-sedatives, BZ-hypnotics, and benzodiazepine-related drugs (BZRD) in adults (≥20 years) were obtained from nationwide registers in Denmark, Finland, Iceland, Norway, and Sweden, 2000-2020. Main measures were therapeutic intensity (TI:DDD/1000 inhabitants [inhab.]/day) and annual prevalence (users/1000 inhab./year). Overall, TI of BZ and related drugs decreased in all Nordic countries from 2004 to 2020. However, there were considerable differences between countries in TI. In 2020, the TI of BZ and related drugs ranged from 17 DDD/1000 inhab./day in Denmark to 93 DDD/1000 inhab./day in Iceland. BZRD accounted for 55-78% of BZ use in 2020, followed by BZ sedatives at 20-44%, BZ-hypnotics at <1-5%, and clonazepam at <1-2%. Annual prevalence of BZ use increased with age in all countries, and the highest annual prevalence was observed among people ≥80 years. Overall, the use of BZ and related drugs has decreased in all Nordic countries from 2004 to 2020, however, with considerable differences in their use between countries. The highest prevalence was observed among the oldest age groups-despite warnings against their use in this population.
Author Andersen, Jacob H.
Saastamoinen, Leena K.
Hallas, Jesper
Gudmundsson, Larus S.
Pottegård, Anton
Højlund, Mikkel
Skurtveit, Svetlana O.
Zoega, Helga
Wastesson, Jonas W.
AuthorAffiliation 4 Research Unit The Social Insurance Institution of Finland (Kela) Helsinki Finland
8 Ageing Research Center Karolinska Institutet & Stockholm University Stockholm Sweden
5 School of Population Health, Faculty of Medicine and Health University of New South Wales Sydney Australia
2 Department of Psychiatry Aabenraa Mental Health Services Region of Southern Denmark Aabenraa Denmark
10 Hospital Pharmacy Funen Odense University Hospital Odense Denmark
9 Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
1 Department of Public Health, Clinical Pharmacology, Pharmacy, and Environmental Medicine University of Southern Denmark Odense Denmark
6 Centre of Public Health Sciences, Faculty of Medicine University of Iceland Reykjavik Iceland
7 Department of Mental Disorders The Norwegian Institute of Public Health Oslo Norway
3 Faculty of Pharmaceutical Sciences University of Iceland Reykjavik Iceland
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Issue 1
Keywords Z-drugs
hypnotics
benzodiazepines
drug utilization
anxiolytics
pharmacoepidemiology
Language English
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Funding information Mental Health Services in the Region of Southern Denmark, Grant/Award Number: A2957; UNSW Scientia Program Award; Riksbankens Jubileumsfond
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Snippet Use of benzodiazepines (BZ) and related drugs is subject to considerable debate due to problems with dependency and adverse events. We aimed to describe and...
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StartPage 60
SubjectTerms Adult
Aged, 80 and over
anxiolytics
Benzodiazepines
Benzodiazepines - adverse effects
Clonazepam
Clonazepam - adverse effects
drug utilization
Drugs
Humans
Hypnotics
Hypnotics and Sedatives - adverse effects
Original
pharmacoepidemiology
Scandinavian and Nordic Countries - epidemiology
Sedatives
Sweden - epidemiology
Z‐drugs
Title Use of benzodiazepines and benzodiazepine‐related drugs in the Nordic countries between 2000 and 2020
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fbcpt.13811
https://www.ncbi.nlm.nih.gov/pubmed/36314353
https://www.proquest.com/docview/2754994039
https://www.proquest.com/docview/2730647733
https://pubmed.ncbi.nlm.nih.gov/PMC10098719
http://kipublications.ki.se/Default.aspx?queryparsed=id:151087714
Volume 132
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