New study on hypnotics correlates them strongly to cancers & early death

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I hemmed and hawed about posting this, because I don't want to cause anyone needless anxiety. However, this is a well-controlled, large sample size statistical analysis from a peer-reviewed journal, and so I think it's worth a mention here:

 

http://bmjopen.bmj.com/content/2/1/e000850.full

 

The upshot of this is that the authors (MDs & PHDs) did a statistical analysis of mortality rates in a hospital among people who were and were not given hypnotics (benzos, z-drugs, antihistamines) and what they found is that people who were given hypnotic sleep aids (even as few as 18 or less doses a year) were significantly more likely to die, and more likely to get cancer, than people in the non-hypnotic group who had similar medical conditions.

 

It's worth pointing out the context, which is that the principle author here runs a website proclaiming the dangers of hypnotics (http://www.darksideofsleepingpills.com/) and also runs a cognitive-based sleep clinic. So, take that as you will.

Abstract

Objectives An estimated 6%–10% of US adults took a hypnotic drug for poor sleep in 2010. This study extends previous reports associating hypnotics with excess mortality.

 

Setting A large integrated health system in the USA.

 

Design Longitudinal electronic medical records were extracted for a one-to-two matched cohort survival analysis.

 

Subjects Subjects (mean age 54 years) were 10 529 patients who received hypnotic prescriptions and 23 676 matched controls with no hypnotic prescriptions, followed for an average of 2.5 years between January 2002 and January 2007.

 

Main outcome measures Data were adjusted for age, gender, smoking, body mass index, ethnicity, marital status, alcohol use and prior cancer. Hazard ratios (HRs) for death were computed from Cox proportional hazards models controlled for risk factors and using up to 116 strata, which exactly matched cases and controls by 12 classes of comorbidity.

 

Results As predicted, patients prescribed any hypnotic had substantially elevated hazards of dying compared to those prescribed no hypnotics. For groups prescribed 0.4–18, 18–132 and >132 doses/year, HRs (95% CIs) were 3.60 (2.92 to 4.44), 4.43 (3.67 to 5.36) and 5.32 (4.50 to 6.30), respectively, demonstrating a dose–response association. HRs were elevated in separate analyses for several common hypnotics, including zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates and sedative antihistamines. Hypnotic use in the upper third was associated with a significant elevation of incident cancer; HR=1.35 (95% CI 1.18 to 1.55). Results were robust within groups suffering each comorbidity, indicating that the death and cancer hazards associated with hypnotic drugs were not attributable to pre-existing disease.

 

Conclusions Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality.

 

Fulltext is at link.

http://i.imgur.com/6ABbG.png

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A few things to note here:

http://www.healthnewsreview.org/2012/02/sleeping-pills-may-kill-12-million-another-example-of-journalists-confusing-association-and-causation/

 

Given the pharmacologic differences between the available prescription drugs, is it likely that they all are associated with the same risk?  As Michael Yurcheshen, MD, an expert quoted by WebMD noted, “It is implausible to think that so many of these medications, spread across several different drug classes, could have the same biological effects.” Yet the media rarely noted this important consideration.  If in fact the sleeping pills were causative, it is also interesting that the association did not vary with the number of doses prescribed.  Or, put another way, there does not appear to be a dose related association.

 

[[rs...]]

spang, thanx for the book. the study is a very large and in depth. very interesting and somehow it doesn't suprise me. If someone had told me I wouldnt be able to take a crap while I go blind and my teeth fall out I never would have taken this poison. I think the only thing to do at this point is to eat a nutricious healthy diet and try to avoid all the poison that is being fed to us. These drugs cause so many health problems. rstud

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The more I have seen this study analyzed the more skeptical I am, actually. The person who pulished it has a financial stake in non drug cures for insomnia, and the numbers just don't add up if you try to analyze them from any angle other than the one the author uses.

 

Hypnotics areoverprescribed, dangerous and of questionable long term utility, but I don't think they are carcinogenic. The author also claims that insomnia by itself is not correlated with increased anger risks, and that is contrary to numerous other studies in more respected journals.

[Guest [...]]

I saw this on some drug email thing I get. Once it would have worried me but I take it all with a grain of salt now. Last year the anti hypertension drug I have been using for over a decade was seen to be causing cancer in a small percentage of users (more than would be expected). I asked my GP at my next visit and he said 'Just wait and see for a few months.'

 

My husband was taking the same drug (lower dose) and seeing a different GP. His doctor told him the same.

 

Lo and behold, a few months later new evidence came up that the researchers had been mistaken and the drug didn't cause increased risk of cancer after all.

 

I have read articles in the past which have stated that long term Valium usage actually DECREASES risk of cancer.

 

I'm going to wait this one out. Not much else I can do. Nearly off the stuff anyway. 

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The author of this study told me in email that he had no evidence that diazepam was problematic in the same way the others listed are. That right there seems weird to me since temazepam is listed by name, and is also a metabolite of diazepam.

 

I swear, if I know more about benzos than the author of the study, something is very wrong with the world.

[[Al...]]

This adds to my fear of getting cancer, having cancer, death, dying....yuk. Hoping it's all withdrawal related thinking.The latter debunking helps.