Dr. Christy Huff blogs on KevinMD about the latest FDA benzodiazepine black box warning and the limitations of the warning:
Some of the important findings from the case series are:
- Adverse events can occur with prescribed therapeutic use: This was true for all but 2 cases in the series.
- Withdrawal can be a long process: The median length of withdrawal symptoms was 9.5 months, with the longest case in the series lasting 8 years!
- Physical dependence can occur within days or weeks: Median time to onset was 14 days (ranging from 1 day to 4 years).
- Abrupt and over-rapid tapers are harming patients: This was a major theme in the 6 example narratives provided. The FDA reviewers postulated that these harms were potentially preventable with a slow taper.
- Physician education about benzodiazepine safety is lacking: The FDA found that there is a “lack of awareness or misconceptions among prescribers about appropriate management of patients taking benzodiazepines.” Fourteen reports requested better prescriber education about the potential for dependence and withdrawal, along with stronger warning labels. Misdiagnosis of benzodiazepine withdrawal was a common theme, often resulting in prescribers increasing the dose of benzodiazepine. Patients were told erroneously that they could safely stop because they were taking a “low dose,” or were instructed to “taper” by halving their dose.
Read The updated benzodiazepine boxed warning: What you need to know HERE