Risk of fracture from benzodiazepine and Z-drugs higher for short-term users

Meta analysis shows that fracture risk is highest among new users of both benzodiazepines and Z-drugs.

X-ray of hip joint

The link between psychotropic drugs and hip fracture is well established, but debate continues about the suitable length of hypnotic prescription.

Researchers carried out a systematic review and meta-analysis of studies involving benzodiazepines, Z-drugs and hip fracture risk. They identified 18 studies involving benzodiazepines and 6 involving Z-drugs. Compared with non-exposure, short-term use (up to 14 days) of benzodiazepines was associated with a 140% increased risk of hip fracture (relative risk [RR] = 2.40, 95% confidence interval [CI] 1.88–3.05), medium-term use carried a 53% increased risk (RR 1.53, 95% CI 1.22–1.92); and long-term use (>month) carried a 20% increased risk (RR 1.20, 95% CI 1.08–1.34). For Z-drugs, short-term use was associated with a 139% increased risk of hip fracture (RR 2.39, 95% CI 1.74–3.29) and mixed-term use carried an 80% increased risk (RR 1.80, 95% CI 1.60–2.02).

Reporting in PLoS ONE
[1]
(27 April 2017) the researchers conclude that patients newly prescribed psychotropic drugs are at the greatest risk of hip fracture and clinicians should consider factors to mitigate the risk.

References

[1] Donnelly K, Bracchi R, Hewitt J et al. Benzodiazepines, Z-drugs and the risk of hip fracture: A systematic review and meta-analysis. PLoS ONE 12(4):e0174730: doi.org/10.1371/journal.pone.0174730

Last updated
Citation
Clinical Pharmacist, CP, June 2017, Vol 9, No 6;9(6):DOI:10.1211/PJ.2017.20202734