Aandacht voor bijwerkingen van benzodiazepinen is belangrijk: een systematisch overzicht

• Benzodiazepines are used frequently, despite the risk of severe side effects.
• The Generic module ‘Side effects; prevention, monitoring and treatment of side effects of drugs for psychiatric disorders’ will be published soon. This contains recommendations for reduction in the risk for falls and fractures, cognitive problems and dependency related to the use of benzodiazepines or Z-drugs (zopiclone, zolpidem).
• Prescribing physicians and pharmacists are compulsorily required to provide extensive information to patients on the anticipated effects and side effects of benzodiazepines, and on the limited prescription period.
• A lot of information has become available from systematic literature reviews by the Benzodiazepines working group. Different benzodiazepines present similar risks of falls and fractures; higher doses present a higher risk, and Z-drugs are no safer.
• In comparison with placebo, benzodiazepines and Z-drugs soon cause cognitive problems, even at low doses and in drugs with a short half-life. There is almost no development of tolerance for these cognitive problems.
• Tailored patient education letters for ceasing benzodiazepine use are more effective than the standard letters. Different dose-tapering schemes have comparable success rates (on average 50%). Augmentation with cognitive behavioural therapy is effective for dose reduction.
• It is therefore important to carefully consider the use of benzodiazepines before using them.

Conflict of interest and financial support: the Benzodiazepines working group received a research subsidy from the quality development network of the Dutch Association of Mental Health and Addiction Care (‘Netwerk Kwaliteitsontwikkeling GGZ’) (number P140019/P140040). Potential conflicts of interests have been reported. ICMJE forms provided by the authors are available online along with the full text of this article.