Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Sedatives in Older People

The British Medical Journal has published a meta-analysis1 of 24 studies to quantify the risks and benefits of short-term sedative treatment in older people with insomnia.

The BBC has reported this study and therefore patients may be aware of this study.

The authors conclude that while there is statistically significant evidence of a beneficial effect upon sleep variables, the benefits are small. They also point out that the clinical effect may be modest and the added risk of adverse events may not justify these benefits.

They go on to suggest that as cognitive based therapies are as effective as pharmacological interventions, and associated with fewer risks they may be a viable alternative.

The Committee on Safety of Medicines (now part of the Medicines and Healthcare products Regulatory Authority) have long advised that benzodiazepines should only be used short-term for insomnia only when it is severe, disabling or causing extreme distress.

Action: Clinicians should be aware of this new study as patients may ask questions about their medication. Any opportunity to reduce and stop benzodiazepine consumption should be exploited to maximum benefit for the patient.

References

  1. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ 2005;331:1169-73

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