Over 60% of patients with psychogenic non-epileptic seizures who were prescribed benzodiazepines before their diagnosis continued the medication in the month following diagnosis, according to a recent study. 

The study examining benzodiazepine (BZD) prescribing patterns in adults with psychogenic non-epileptic seizures (PNES) in the U.S. found that a notable proportion of patients continued BZD use following diagnosis. The analysis, utilizing a nationwide claims database of 20,848 adults newly diagnosed with PNES from 2016 to 2022, reported that 33.1% of patients received BZDs in the year preceding their PNES diagnosis, and 15.1% received BZDs in the month prior. Post-diagnosis, 18.1% of patients continued BZD treatment, with clonazepam, alprazolam, and lorazepam being the most prescribed agents.

Researchers observed that 62.9% of patients who had been prescribed BZDs in the month before their PNES diagnosis continued to receive these medications in the month following diagnosis. In comparison, only 5.4% of patients without prior BZD use initiated therapy post-diagnosis. Anxiety disorders, but not epilepsy, were strong independent predictors of continued BZD receipt after PNES diagnosis.

The findings, published in BMJ Open Neurology, suggest that the effects of BZD use in this population, particularly in patients with psychiatric comorbidities, warrant further investigation. While new BZD prescriptions were rare among patients without prior exposure, continuation of BZD therapy in those previously receiving the medication may conflict with clinical practice guidelines that recommend tapering in the management of PNES.

Full disclosures can be found in the published study.