The risks outweigh the benefits in the use of benzodiazepines to treat patients with posttraumatic stress disorder (PTSD), according to a meta-analysis in the July issue of the Journal of Psychiatric Practice. Furthermore, the results suggest that use of benzodiazepines in patients who have recently experienced trauma may increase the risk for developing PTSD. 


Lead author Jeffrey Guina, MD, and colleagues reviewed 18 studies and a total of 5,236 individuals with one or more traumatic experiences, such as physical injuries, life-threatening medical conditions, combat-related trauma, sexual trauma, and disasters. They found that benzodiazepines were not associated with improvement in overall severity, psychotherapy outcomes, aggression, depression, and substance use in these patients, but the drugs did worsen outcomes in these characteristics. In addition, the authors determined that benzodiazepines significantly increased the risk for developing PTSD when used after recent trauma, with some studies finding risks for developing PTSD that were two to five times higher in those taking benzodiazepines than in control groups. 


“The results of this systematic review suggest that benzodiazepines should be considered relatively contraindicated for patients with PTSD or recent trauma,” the authors wrote. “Evidence-based treatments for PTSD should be favored over benzodiazepines.”