Do Benzodiazepines increase PTSD, especially for those who have experienced major trauma?
The first systematic review on benzodiazepines for the prevention or treatment of post-traumatic stress disorder (PTSD) determined that there is insufficient evidence to support the use of these drugs, and that they could actually increase the likelihood of developing PTSD when taken by trauma patients.
Benzodiazepines are prescribed to approximately 30–70% of patients with PTSD, even though some guidelines state that they are contraindicated for combat-related PTSD, traumatic grief, or all PTSD.
Published in the Journal of Psychiatric Practice, this review evaluated 18 clinical trials and observational studies measuring PTSD outcomes in 5,236 patients taking benzodiazepines.
Patients survived one or more of the following: physical injuries, life-threatening medical conditions, combat-related trauma, sexual trauma, disaster exposure, and other traumas. About 67% survived a physical injury, mean age was approximately 44 years, and around 38% were women.
The authors found that there was no evidence that benzodiazepines alleviated PTSD-associated symptoms in PTSD patients or prevented the development of PTSD in trauma patients.
In fact, benzodiazepines increased the likelihood of
developing PTSD when taken by trauma patients in the research included in this review. The risks, particularly effects on memory with benzodiazepine use, could prevent patients from learning to cope with PTSD symptoms.
The authors concluded that benzodiazepines are "relatively contraindicated" in trauma patients and that psychotherapy, antidepressants, and adrenergic inhibitors should considered before benzodiazepines in patients with PTSD.
This article was first published in journals.lww.com