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Concurrent benzodiazepine use in older adults treated with antidepressants in Asia

Published online by Cambridge University Press:  07 December 2017

Xiao-Mei Zhong
Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Hui Hospital), Guangzhou, China Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
Fei Wang
Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
Qinge Zhang
The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
Gabor S. Ungvari
The University of Notre Dame Australia/Marian Centre, Perth, Australia Graylands Hospital, Perth, Australia
Chee H. Ng
Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
Helen F. K. Chiu
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
Tian-Mei Si
Peking University Institute of Mental Health (the sixth hospital) & National Clinical Research Center for Mental Disorders & the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
Kang Sim
Institute of Mental Health, Buangkok View, Buangkok Green Medical Park, Singapore
Ajit Avasthi
Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Sandeep Grover
Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Mian-Yoon Chong
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan
Kok-Yoon Chee
Department of Psychiatry & Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
Shigenobu Kanba
Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
Min-Soo Lee
Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
Shu-Yu Yang
Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
Pichet Udomratn
Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Roy A. Kallivayalil
Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, India
Andi J. Tanra
Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Sulawesi Selatan, Indonesia
Margarita M. Maramis
Dr. Soetomo Hospital – Faculty of Medicine, Airlangga University, Jawa Timur, Indonesia
Winston W. Shen
Departments of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taiwan
Norman Sartorius
Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
Rathi Mahendran
Department of Psychological Medicine, National University of Singapore, Singapore
Chay-Hoon Tan
Department of Pharmacology, National University of Singapore, Singapore
Naotaka Shinfuku
International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
Yu-Tao Xiang*
Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
Correspondence should be addressed to: Dr Yu-Tao Xiang, Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau SAR, 3/F, Building E12, China. Phone: +853-8822-4223; Fax: +853-2288-2314. Email:



Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates.


The data of 955 older adults with any type of psychiatric disorders were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Both univariate and multiple logistic regression analyses were performed.


The proportion of benzodiazepine and antidepressant combination in this cohort was 44.3%. Multiple logistic regression analysis revealed that higher doses of antidepressants, younger age (<65 years), inpatients, public hospital, major comorbid medical conditions, antidepressant types, and country/territory were significantly associated with more frequent co-prescription of benzodiazepines and antidepressants.


Nearly, half of the older adults treated with antidepressants in Asia are prescribed concurrent benzodiazepines. Given the potentially adverse effects of benzodiazepines, the rationale of benzodiazepines and antidepressants co-prescription needs to be revisited.

Original Research Article
© International Psychogeriatric Association 2017 

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These authors contributed equally to this work.


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