Benzodiazepines Tied to Worse Outcomes in Progressive Supranuclear Palsy

— Drugs are frequently recommended to deal with sleeping disorders, stress and anxiety in PSP

by
Judy GeorgeDeputy Managing Editor, MedPage Today
January 23, 2024

Individuals with progressive supranuclear palsy (PSP) who were recommended benzodiazepine derivatives had a much faster decrease in PSP Rating Scale (PSPRS) ratings than those who didn’t have benzodiazepines, a post hoc analysis revealed.

In a secondary analysis of concomitant substance abuse in a stage II/III medical trial, just one medication class– benzodiazepine derivatives, consisting of lorazepam, clonazepam, alprazolam, and diazepam– was related to more quick worsening of PSPRS ratings (P< 0.001), reported Anne-Marie Wills, MD, MPH, of Massachusetts General Hospital in Boston, and co-authors.

Benzodiazepine-related drugs such as zolpidem, zopiclone, and eszopiclone were not associated with aggravating PSPRS ratings, they composed in a JAMA Neurology research study letter.

“This research study is the very first to take a look at the results of medications that are utilized scientifically to deal with PSP,” Wills informed MedPage Today

“We discovered that benzodiazepines are related to much quicker illness development,” she stated. “This is necessary since these medications are frequently recommended to clients with PSP for sleeping disorders and stress and anxiety, to name a few signs.”

The findings recommend there might be other flexible elements that can impact PSP development, Wills included.

The scientists evaluated 305 individuals in the stage II/III randomized trial of davunetide for PSP. Due to the fact that the trial reported no treatment impactboth the davunetide and placebo groups were consisted of.

Over half of trial individuals were ladies (53%) and the mean age at screening had to do with 68. Of 305 individuals, 44 (14.43%) took benzodiazepines and 38 (12.46%) took benzodiazepine-related drugs.

The research study covered 52 weeks up until November 2012. Its primary result consisted of duplicated PSPRS steps, which evaluated impairment throughout 6 domains with an optimal rating of 100. Greater ratings suggested more illness worsening.

A considerable distinction emerged in between individuals not taking versus taking benzodiazepines at week 39 (7.52 vs 12.10 PSPRS points, P< 0.001) and week 52 (10.02 vs 16.69 PSPRS points, P< 0.001).

After changing for standard illness intensity and for benzodiazepine indicators like sleeping disorders, stress and anxiety, sleep disruption, agitated legs syndrome, and anxiety, individuals taking benzodiazepines experienced a mean worsening of 17.1 PSPRS points annually, compared to 9.9 points annually for those not taking benzodiazepines.

“There was no distinction in between individuals recommended benzodiazepines before versus throughout the research study, refuting faster PSP development causing benzodiazepine prescription,” Wills and co-authors observed.

“Duration and dosage of benzodiazepine direct exposure did not seem related to the rate of modification in PSPRS, possibly due to the restricted sample size,” they included.

Research study constraints consist of confounding by unmeasured variables and vulnerability to predisposition in a retrospective observational analysis, the scientists acknowledged. “We were not able to develop any causal relationship in between benzodiazepines and getting worse illness,” they composed. “In addition, irregular research study check outs prevented our capability to examine intense symptomatic impacts of benzodiazepines.”

The davunetide trial registered just individuals with Richardson’s syndrome (the most typical medical discussion of PSP), and the findings of this secondary analysis are not generalizable to other PSP versions, they explained. The sample size of the benzodiazepine group and the fairly brief follow-up in the trial likewise are constraints.