Benzodiazepine overuse in an internal medicine out-patient department: a prospective study

Objective: This study aims to assess benzodiazepine overuse, in particular indications, prolonged use, and dependence for usage in out-patients treated at the internal medicine clinic of Chiang Mai University Hospital. Methods: The indications of benzodiazepine usage were examined by using the Thai Hospital Anxiety and Depression Scale in patients who were started on benzodiazepines. The duration of benzodiazepine usage was classified into: i) less than 1 month; ii) 1-6 months; and iii) longer than 6 months, and benzodiazepine dependence was assessed by using the Severity of Dependence Scale. Results: Of 40 out-patients started on benzodiazepines, only one of them (2.5%) had clinically significant anxiety. Of 58 outpatients receiving benzodiazepines, 42 patients (72.4%) had used benzodiazepines longer than 6 months. In addition, 8 patients (13.8%) were dependent on benzodiazepines. Conclusions: Benzodiazepine overuse is common in physically ill out-patients, even in the university hospital. Almost half of the surveyed patients appear to have prolonged benzodiazepine use; however, only a few patients are dependent on benzodiazepines