Doctors Continue To Prescribe Benzos For Depression, Despite Guidelines

Nearly 1 in 10 patients treated for depression are only given benzodiazepines, like Valium and Xanax, despite clinical guidelines that say benzodiazepines should not be used alone for the treatment of depression. 

The findings, published in the Journal of Clinical Psychiatry, show a disconnect between established best practices and what is actually happening in the treatment of depression patients. 

“Depression guidelines discourage benzodiazepine monotherapy and limit use to short-term adjunctive therapy with antidepressants; however, patients with depression continue to receive benzodiazepine monotherapy,” study authors wrote. 

They continued, “Whereas practice guidelines consider antidepressants and psychotherapy as primary treatment options, they either do not mention or fail to endorse benzodiazepine monotherapy for the treatment of [major depression].”

Who's More Likely To Get A Benzo Script?

The study also identified patterns in which depression patients were solely being treated with benzodiazepines. Older patients (ages 45-64) and those with Medicare were more likely to be prescribed just benzodiazepines than younger patients and those with private insurance, according to Psychiatry Advisor. 

In addition, having other medical conditions including epilepsy, pulmonary disease and opioid use also increased the likelihood of being given just benzodiazepines, despite the known risks of benzos for people with these conditions. 

“A number of these variables contradict known concerns about benzodiazepines and their risk of dependence and delirium, especially with concomitant opioids,” Emily Pond wrote for Psychiatry Advisor. 

The "X" Factor

The study found that the most common benzos that were prescribed alone to people with major depression were alprazolam (brand name: Xanax) which made up more than 42% of prescriptions; lorazepam (brand name: Ativan), which made up nearly 28% of prescriptions; clonazepam (brand name: Klonopin), which made up 20% of prescriptions; and diazepam (brand name: Valium), which constituted nearly 14% of prescriptions.

Although benzodiazepines are effective for treating anxiety, they are also potentially dangerous. According to a presentation by the Substance Abuse and Mental Health Services Administration (SAMHSA), “most people” will become dependent on benzos in less than 6 weeks, and only 30% of people who have become dependent on benzos will ever fully get off the pills. In part, that’s because withdrawing from benzos can be dangerous. 

Researchers pointed out that doctors need to be better educated about the risk of treating depression solely with benzodiazepines.

“Educational or technological interventions to minimize benzodiazepine monotherapy utilization should be implemented to raise the awareness of the impact of this treatment modality on patients with [major depressive disorder],” the study authors wrote.