McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Clinical Reviews & Editorials
Deprescribing BZRAs taken for insomnia: A review and key messages from practice guidelines

Deprescribing BZRAs taken for insomnia: A review and key messages from practice guidelines

2019-02-01

Justin Y. Lee, Barbara Farrell, Anne Marie Holbrook

From Polish Archives of Internal Medicine.

Full article

A PDF of the full version of the article can be accessed free of charge through the website of Polish Archives of Internal Medicine.

Abstract

Long-term benzodiazepine receptor agonist (BZRA) use for insomnia is common and highly prevalent in adults in all care settings. Evidence syntheses suggest that the therapeutic benefits of benzodiazepines for insomnia are marginal and very short term. On the harm side, BZRAs are associated with daytime sedation and confusion. Long-term use increases the risk of falls, fractures, cognitive impairment, and motor vehicle accidents.

An evidence-based clinical practice guideline has been developed to assist with deprescribing BZRAs. This review highlights the rationale for deprescribing BZRAs used for insomnia and summarizes key messages for clinicians from the new BZRA deprescribing guideline and their supporting evidence.

See also

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Current management of acute diarrheal infections in adults This review addresses a range of problems associated with acute diarrheal infections in light of the 2016 guidelines on the management of acute diarrhea in adults.
Advances in the treatment of mild asthma: Recent evidence This review explores advances in the treatment of asthma in light of recently published data.
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Summarizing the evidence: from questions to facts A lecture by Dr Gordon Guyatt delivered at Evidence-Based Medicine and Clinical Practice Guidelines in Contemporary Practice in Kraków in May 2017.
Chronic headache: repeated imaging studies and neurologic consultation When should we refer a patient with chronic headache treated in a pain clinic for repeated imaging studies? When should neurologic consultation be repeated?

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