Quality Prescribing for Benzodiazepines and z-drugs A Guide for Improvement 2024-2027

Appendix 5: Patient information leaflet

Background

Benzodiazepines and z-drugs, also known as sedatives, anxiolytics and sleeping tablets, have limited therapeutic effects, and are known to cause a range of avoidable adverse drug effects and harms. Dependence (both physical and psychological) and tolerance (loss of effect) can develop quickly within weeks of starting them. Therefore, when they are needed, they should only be prescribed for a short course (e.g. maximum of seven days). However, some individuals may have received longer courses of treatment which may lead to difficulty withdrawing the drug after taking it regularly for more than a few weeks. It also exposes individuals to avoidable drug-related harms which can be reduced by reviewing, reducing and stopping treatment where appropriate.

What is the purpose of the benzodiazepines and z-drugs quality prescribing guide?

It is intended to:

• Empower and help people who receive benzodiazepines and/or z-drugs, and prescribers to review these medicines to ensure the best treatment for the individual.
• Improve the support available from the healthcare system for individuals experiencing dependence on, or withdrawal from, prescribed medicines.
• Help prescribers identify individuals who may benefit from a benzodiazepine and/or z-drug review and support routine medicines reviews.
• Provide a range of options, where appropriate, for individuals that have completed their course of benzodiazepines and/or z-drug treatment and are appropriate to reduce and stop their benzodiazepine and/or z-drug.

Do I need to have my benzodiazepines and z-drug reviewed?

• Yes, as benzodiazepines and z-drugs:
• Have limited effects for reducing anxiety, insomnia and muscles spasms.
• Are known to be associated with a range of avoidable adverse effects and harms:
  • depression and low mood
  • memory loss and dementia
  • falls and hip fractures
  • increase in road traffic accidents
  • paradoxical effects: insomnia, anxiety, irritability, etc.
  • addiction
• Having medicines reviewed regularly creates an opportunity to discuss if a medicine needs to continue and consider effective non-medicine treatments and lifestyle changes that may help.

Do I need to stop my benzodiazepines and z-drug?

• It may be appropriate for some individuals to stop, but not for others.
• Continuing treatment maybe appropriate because there are more benefits to continuing than risks of stopping treatment e.g. epilepsy, Parkinson’s disease.
• Reducing and/or stopping may be necessary to reduce the risk of avoidable adverse effects and harms e.g. falls, confusion, sedation, etc.

How should I stop my benzodiazepines and z-drugs?

If you are ready to stop your benzodiazepines and z-drugs:

• Arrange a review with your general practice doctor, pharmacist or nurse.
• Discuss stopping your medicine and agree if this is appropriate.
• If appropriate to stop, then plan and agree the best way to do this for you considering the options outlined in the benzodiazepines and z-drug quality prescribing guide.