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
(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.


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