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Association Between Benzodiazepine Use and Epilepsy Occurrence: A Nationwide Population-Based Case-Control Study
Tomor Harnod1, Yu-Chiao Wang, Chia-Hung Kao
1From the Department of Neurosurgery, Hualien Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan (TH); College of Medicine, Tzu Chi University, Hualien, Taiwan (TH); Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan (Y-CW); College of Medicine, China Medical University, Taichung, Taiwan (Y-CW); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (C-HK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
Benzodiazepine (BZD) use is linked to a doubled epilepsy risk. Higher doses and longer BZD exposure significantly increase this risk, even after cessation.
Area of Science:
- Neuroscience
- Pharmacology
- Epidemiology
Background:
- Benzodiazepine (BZD) medications are widely prescribed.
- Epilepsy is a chronic neurological disorder affecting millions worldwide.
- The relationship between BZD use and epilepsy risk requires further investigation.
Purpose of the Study:
- To evaluate the association between benzodiazepine (BZD) use and the risk of developing epilepsy.
- To explore dose-response and duration-response relationships between BZD exposure and epilepsy.
- To assess epilepsy risk in individuals who have ceased BZD use.
Main Methods:
- Retrospective case-control study using Taiwan National Health Insurance Research Database.
- 1065 epilepsy patients (aged ≥20) frequency-matched with 4260 controls.
- Logistic regression analysis to calculate odds ratios (OR) for BZD exposure and epilepsy risk.
Main Results:
- BZD use was associated with a 2.02-fold increased epilepsy risk (aOR=2.02).
- Epilepsy risk increased with higher BZD doses (≥1.50 DDD: aOR=4.32) and longer exposure duration (≥35 days/year: aOR=5.60).
- Increased epilepsy risk persisted even after BZD cessation for over 6 months.
Conclusions:
- Benzodiazepine use significantly elevates epilepsy risk.
- Prolonged, high-dose, or frequent BZD exposure amplifies this risk.
- The association between BZD use and epilepsy warrants clinical attention, especially regarding long-term use and cessation periods.
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