Psychiatry AdvisorBaseline Benzodiazepine Exposure Modulates Risk for Transition to Psychosis

Baseline Exposure to Benzodiazepines in High-Risk Individuals May Increase Likelihood of Progressing to Psychosis

A recent meta-analysis published in Psychological Medicine has revealed a potential link between initial exposure to benzodiazepines (BDZs) and an increased risk of transitioning to psychosis in individuals at clinical high-risk (CHR-P).

HCN Medical Memo
This study underscores the importance for healthcare professionals to consider the potential risks associated with baseline exposure to BDZs when treating individuals at CHR-P. The findings suggest that such exposure may increase the likelihood of these individuals transitioning to psychosis.

Key Points

• The meta-analysis included five studies with participants having a mean age of 19.7 years, half of whom were female.
• The follow-up period lasted up to 12 months in four studies and 36 months in one study.
• The percentage of individuals exposed to BDZ at the start of the studies ranged from 5.5% to 46.2%, with an average of 16.8%.
• During the follow-up period, 28.4% of individuals in the cases group developed psychosis, compared with only 9.3% in the control group.
• Individuals already being treated with BDZs at the beginning of the study were found to have more than twice the likelihood of transitioning to psychosis compared to those who were BDZ-naive.

“The greatest medicine is to teach people how not to need it.”
– Hippocrates

Additional Points:

• There was no significant heterogeneity across the studies, indicating consistency in the findings reported.
• The limitations of the meta-analysis include the inability to analyze how dosage information or concomitant prescription of other medications may have impacted the transition to psychosis.

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