Journal Article Annotations
2021, 1st Quarter
Annotations by Timothy Kong, MD
PUBLICATION #1 — Cardiac Psychiatry
This study examined the risk of developing posttraumatic stress disorder or symptoms after exposure to benzodiazepines, beta-blockers, or opioid medications in the setting of acute coronary syndrome. The authors followed up with patients 3 months after the acute event and found that patients who were exposed to benzodiazepines had higher rates of post-traumatic stress disorder/symptoms after controlling for other variables.
Strength and weaknesses:
The authors of the study had controlled multiple factors including depression history, and antidepressant use. However, they did not characterize baseline anxiety symptoms or disorders which may lead to post-traumatic stress symptoms/disorders later after a cardiac event and also associate with treatment decisions in the aftermath of a coronary event.
Use of benzodiazepines are occasionally utilized by psychiatrists in the setting of treatment of anxiety, especially in patients with cardiac conditions and potential complications, for example, with prolonged QTC. This relatively small study (n=154), should make psychiatrists reconsider the role of benzodiazepines in the treatment of anxiety in patients with acute coronary syndrome and more strongly consider alternative therapies.
Type of study:
(EBM guide): Cohort study