BMJ

Deprescribing benzodiazepines and sedative hypnotics: Pharmacist-led interventions may help

July 17, 2025

The evidence for deprescribing benzodiazepines and closely related sedative hypnotics is limited by low certainty. However, patient education, medication review, and pharmacist-led education may modestly increase discontinuation rates without significant adverse effects.

Study details. This systematic review and meta-analysis included 49 unique randomized controlled trials (58 publications, >39,000 patients) assessing interventions to deprescribe these drugs in adults with insomnia. Interventions were grouped as tapering, patient education, physician education, combined education, cognitive behavioral therapy, medication review, mindfulness, motivational interviewing, pharmacist-led interventions, and drug-assisted withdrawal. Certainty of evidence was rated using the GRADE approach.

Results. Low certainty evidence suggests that patient education (144 more discontinuations per 1,000; 95% confidence interval [CI], 61–246), medication review (104 more per 1,000; 95% CI, 34–191), and a pharmacist-led educational intervention (491 more per 1,000; 95% CI, 234–928) may increase drug discontinuation rates compared with usual care. Moderate certainty evidence indicates patient education probably has little or no effect on physical function, mental health, or insomnia symptoms. No compelling evidence was found for other interventions, and no high or moderate certainty evidence indicated increased dropouts. Multicomponent interventions may be more effective than single-component approaches (low certainty evidence).

Source:

Zeraatkar D, et al. (2025, June 17). BMJ. Comparative effectiveness of interventions to facilitate deprescription of benzodiazepines and other sedative hypnotics: systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/40527546/