A population-based cohort study of anxiety, depression, sleep and alcohol outcomes among benzodiazepine and z-hypnotic users

ObjectiveThe present study aimed to examine anxiety, depression, sleep and alcohol outcomes among individuals who were prescribed benzodiazepines or z-hypnotics in a Norwegian population-based sample (n = 58 967).MethodsThis 13 year historical cohort study obtained baseline measures of self-report anxiety, depression, sleep difficulties and alcohol use from the Nord-Trøndelag Health Study (HUNT 2, 1995–1997). Information about outcomes was collected from the third wave (HUNT 3, 2006–2008) of the same epidemiological study. Prescription records of benzodiazepines and z-hypnotics were obtained from the Norwegian prescription database (NorPD, 2004–2008) and were linked to the HUNT 2 and HUNT 3 questionnaire data.ResultsAmong the 58,967 respondents who were eligible for the study, 13,774 (23%) received at least one prescription of benzodiazepines or z-hypnotics in the period 2004–2008.Benzodiazepine use was associated with a higher risk of severe anxiety, depression and sleep outcomes. The assumption that benzodiazepine use is prospectively associated with a higher risk of problematic alcohol use was not supported.ConclusionsConsideration and discussion of the future place of benzodiazepines in treatment of anxiety and sleep difficulties in Norway could be warranted. Benzodiazepines may be efficient in reducing symptoms in the short term, but evidence from this long temporal follow-up study indicates limited positive influences in the long term.

► BZD use was related to more anxiety, depression and sleep burden at follow-up.
► The study did not support that bzd use is related to later alcohol use.
► BZD may reduce symptoms in the short term, but long term use is not endorsed.
► The role of bzd in treatment of anxiety and sleep difficulties is discussable.