Submitted:
16 December 2025
Posted:
18 December 2025
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Abstract
Background and Objectives: Benzodiazepines (BZDs) are among the most widely prescribed psychotropic drugs globally, and Lithuania is no exception. People with osteoarthritis (OA) often experience chronic pain before arthroplasty, which can cause insomnia, anxiety, and mood disturbances, sometimes leading to BZDs or Z drug prescriptions. The use of these medications, particularly over the long term, may adversely affect cognitive function and increase the risk of falls. Cognitive and psychomotor impairments may hinder rehabilitation, delay mobilization, and reduce quality of life after elective arthroplasty. The aim of this study was to evaluate the prevalence of psychotropic drugs among Lithuanian elderly patients undergoing elective arthroplasty. Materials and Methods: The study, approved by the Regional Bioethics Committee (No. BE-2-53), was conducted at the Department of Anesthesiology, Hospital of the Lithuanian University of Health Sciences Kaunas Clinics. Data on psychotropic medication use, underlying conditions, and treatment duration were obtained from the Hospital’s Information System. Participants were adults aged ≥65 years scheduled for elective arthroplasty with ASA physical status I–III. Data were presented as frequencies (n) and percentages (%). Results: A total of 362 participants were enrolled, of whom 223 (61.6%) used psychotropic medications. Most (63.2%) took BZDs, mainly bromazepam (29.1%) and alprazolam (27.4%). The leading indication was sleep disorders (38.1%), most often treated with alprazolam (34%), followed by anxiety disorders (20.2%), typically managed with bromazepam (24.8%). 99% of participants had been receiving BZDs for more than four weeks. Conclusions: Over half of Lithuanian OA patients undergoing elective arthroplasty used BZDs, underscoring the need for cautious, evidence-based prescribing – particularly in older adults. Regular medication reviews, adherence to national and EU guidelines, and greater use of non-pharmacological therapies are advised. Future research should examine drivers of chronic BZDs use and evaluate deprescribing and alternative treatments for safer, more sustainable care.
