IATROGENIC BENZODIAZEPINE WITHDRAWAL DELIRIUM IN HOSPITALIZED OLDER PATIENTS

OBJECTIVE: The purpose of this review was to identify cases of benzodi azepine withdrawal delirium in a population of older hospitalized pati ents and to determine whether the withdrawal was caused by iatrogenic factors. DESIGN: Retrospective chart review of selected cases from a r eferred sample. A Bayesian Adverse Reactions Diagnosis Instrument (BAR DI) was applied to cases of benzodiazepine withdrawal delirium to quan tify the probability that drug withdrawal was the causative mechanism. SETTING: A university-affiliated health sciences center. PATIENTS: A review of the psychiatric consultation liaison service database for a consecutive 4-month period yielded 21 cases of delirium in a referred sample of 119 patients more than 65 years of age. Four cases of benzod iazepine withdrawal were identified within the group of patients with delirium, and retrospective chart review identified potential iatrogen ic causes for withdrawal in three patients. RESULTS: The posterior pos sibilities calculated by the BARDI for the three cases of delirium wer e 0.98, 0.95, and 0.75, indicating a high probability that the deliriu m was caused by benzodiazepine withdrawal. CONCLUSIONS: Benzodiazepine withdrawal delirium in older hospitalized patients may be associated with iatrogenic factors.