Benzodiazepine use in the elderly prior to psychiatric hospitalization

The objective of this study was to assess benzodiazepine use and the treatment of depression before admission to an inpatient geriatric psychiatry unit in a sample of elderly patients. The study design was a retrospective chart review, and the setting was a university hospital inpatient geriatric psychiatry unit. The subjects included 131 consecutively admitted patients. Preadmission benzodiazepine drug regimens were reviewed in relation to the Health Care Financing Administration (HCFA) guidelines for benzodiazepine use in nursing homes and in relation to psychiatric diagnoses. Psychiatric diagnoses were made based on DSM-III-R criteria. The preadmission benzodiazepine regimens of 38 of 59 patients receiving benzodiazepines (64.0%) were outside the HCFA guidelines. Also, 30 of 76 patients (39.5%) with depressive disorders received benzodiazepines as sole treatment of depression prior to their admission. This study suggests that benzodiazepines may be misused in the elderly and indicates the need for education and research on the appropriate use of benzodiazepines in the treatment of depression.