In Alzheimer Disease, Opioids May Lower Benzodiazepine Use
Opioid initiation may help lower antipsychotic and benzodiazepine (BZDR) use among patients with Alzheimer disease (AD), according to new findings.
In a study of patients who were enrolled in the Medication use and Alzheimer's disease (MEDALZ) cohort, researchers compared patient outcomes associated with opioid initiation (n = 3327) vs non-opioid initiation (n = 3325).
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Using interrupted time series analyses, the prevalence of antipsychotic and BDZR use was compared in 30-day periods within 6 months before opioid initiation to 30-day periods 6 months later.
Antipsychotics were used by approximately 13.3% of opioid initiators before opioid initiation, 18.3% at the time of opioid initiation, and 17.3% at 6 months post-opioid initiation. In addition, the prevalence of BDZR use among opioid initiators was 27.1% at 6 months pre-opioid initiation, 28.9% at the time of opioid initiation, and 26.9% at 6 months post-opioid initiation.
Ultimately, the researchers found that opioid initiation was associated with a 0.3% and 0.4% drop per month in antipsychotic and BZDR use, respectively, until the end of follow-up.
The researchers noted that, although opioid initiation vs non-opioid initiation was associated with an immediate increase in prevalence of 1.9 percentage points for antipsychotic use and 1.6 percentage points for BZDR use, they observed a comparative decrease of 0.5 percentage points per month for antipsychotics and 0.4 percentage points per month for BZDR use until the end of follow-up.
“Our results suggest that opioid initiation may reduce antipsychotic and BZDR use among persons with AD,” the researchers concluded.
—Christina Vogt
Reference:
Hamina A, Lavikainen P, Tanskanen A, et al. Impact of opioid initiation on antipsychotic and benzodiazepine and related drug use among persons with Alzheimer's disease [Published online March 21, 2018]. Int Psychogeriatr. https://doi.org/10.1017/S1041610217002897.