The prevalence of a positive screening for depression (score greater than or equal to 8) at 6 months post-ALI was 26%. Depressive symptoms were significantly associated with surgical (vs. medical or trauma) ICU admission (relative risk [RR] 2.2, 95% confidence interval [CI] 1.1-4.2), maximum daily Sequential Organ Failure Assessment Score of greater than10 (RR 2.1, 95% CI 1.1-3.5), and mean daily ICU benzodiazepine dose of greater than or equal to 75 mg of midazolam equivalent (RR 2.1, 95% CI 1.1-3.5).
This adverse effect of benzodiazepine sedation seems to be related to dosage, as do various adverse effects unique to other sedative agents, highlighting the need to minimize sedative doses. I wonder if we would be better off using combinations or agents or alternating agents.
Medscape commentary here.