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Benzodiazepines ineffective for treatment, prevention of PTSD

Benzodiazepines are ineffective for treatment and prevention of PTSD and thus should be considered relatively contraindicated for patients with PTSD, according to results from a systematic review.

“The use of benzodiazepines in the treatment of [PTSD] is both common and controversial. Although [benzodiazepines] are prescribed to 30% to 74% of patients with PTSD, there is little literature — and no reviews before this article — focusing exclusively on the use of [benzodiazepines] to prevent or treat PTSD,” study researcher Jeffrey Guina, MD, of Wright State University and Wright-Patterson Air Force Base Medical Center, and colleagues wrote.

Jeffrey Guina

Researchers analyzed data from 18 clinical trials and observational studies measuring PTSD outcomes among patients using benzodiazepines (n = 5,236).

Analysis indicated benzodiazepines were ineffective at treating and preventing PTSD. The risks associated with use of benzodiazepines among patients with PTSD outweigh potential short-term benefits, according to researchers.

Benzodiazepines were associated with significant adverse events among patients with PTSD, including worse overall disease severity, increased risk for developing PTSD after recent trauma, worse psychotherapy outcomes, aggression, depression and substance use.

“Based on our meta-analysis and qualitative synthesis, we can conclude that [benzodiazepines] are more likely to be ineffective than effective for the treatment or prevention of PTSD and that risks tend to outweigh potential short-term benefits. Consistent evidence supports a lack of efficacy, especially for PTSD core symptoms, psychotherapy augmentation, and depression,” Guina and colleagues wrote. “There is also suggestive evidence that [benzodiazepines] may worsen outcomes, with [benzodiazepines] being correlated with worse overall severity of PTSD symptoms, increased risk of trauma patients developing PTSD, and worse psychotherapy outcomes. However, more double-blind placebo-controlled trials are needed before it can be concluded that [benzodiazepines] consistently worsen PTSD.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.