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Link Found Between Use of Some Anti-Anxiety Medications and Alzheimer’s Disease

The British Medical Journal (BMJ) just published a new study with disturbing information. A class of medications called Benzodiazepines which are commonly used by doctors of all specialties to treat anxiety has been found to increase the risk of developing Alzheimer’s disease later in life.

What are Benzodiazepines?

Benzodiazepines are a group of medications that are used by doctors across all specialties for treatment of anxiety and insomnia. Xanax (Alprazolam), Ativan (Lorazepam), Klonopin (Clonazepam), Valium (Diazepam), and Restoril (Temazepam) are commonly used Benzodiazepines.

The medications in the Benzodiazepine class have both a calming, and a sedating effect on people, therefore they have been broadly used to treat both anxiety, and insomnia. They are not meant to be used long-term because people who use them regularly can develop both tolerance to, and dependence on the medication.

Tolerance occurs when a person can no longer get the same effect with the medication. For example, John Doe was prescribed 1 mg of Ativan to treat his insomnia. Although John slept well on this dose initially, after about six months, the Ativan stopped working. His doctor then increased his dose to 2 mg, and the same pattern happened. Now, John Doe takes 4 mg of Ativan, and still can’t sleep. John Doe has developed tolerance to his Ativan.

Dependence occurs when the person taking the medication experiences discomfort if he or she stops the medication. As an example, say Jane Doe is prescribed 2 mg of Xanax, and she has been taking her Xanax three times a day for her anxiety. She decides to go on a trip and forgets to take her Xanax with her. During her trip, she starts sweating, shaking, and her heart rate goes up. She is also feeling extremely irritated with everyone and feels like she is crawling out of her skin. She is experiencing withdrawal from her Xanax because she has developed dependence on it. Withdrawals from Benzodiazepines can have severe consequences such as seizures, comma, and even death. This is why people who have dependence on high doses of Benzodiazepines should go through detoxification in a hospital where they are weaned off the medication gradually under medical supervision.

What is Alzheimer’s disease?

Alzheimer’s disease is a form of dementia that occurs mostly in the elderly population. The brain of a person with Alzheimer’s disease goes through gradual, irreversible changes that lead to lower and lower functioning, and ultimately, death. Alzheimer’s disease is a devastating disease without a cure, and people afflicted with this disease gradually lose their memory and independence over the course of years. Although there is no cure for the disease, there are preventative life style and diet changes that people can make to lower their risk of developing Alzheimer’s. There are also medications that slow down the course of the disease.

What is the “link” between Alzheimer’s and Benzodiazepine use?

The BMJ study looked at a large population of the elderly that suffer from Alzheimer’s disease, and compared them to a population of elderly that do not have the disease. The study looked at the number of people in each group that had been exposed to Benzodiazepines in the past. In the Alzheimer’s group, a higher percentage of people had a history of having been exposed to Benzodiazepines for a prolonged period of time (over six months). The study concluded that people who have been exposed to Benzodiazepines for more than 6 months in their lives are 1.5 times more likely to develop Alzheimer’s disease than people with less exposure. To put this in perspective, it means that in a population of people over 65 years old who were not exposed to Benzodiazepines, out of every 200 people, approximately 20 people will be diagnosed with Alzheimer’s disease, while in a population of people over 65 years old who were exposed to Benzodiazepines, approximately 30 people out of 200 will be diagnosed with Alzheimer’s disease.

What does this data mean for the average person’s risks of developing Alzheimer’s disease?

This study is not the first one to find a link between Benzodiazepines and Alzheimer’s disease. This new data is more support for previous studies that had similar results. The BMJ study has its limitations just as other studies do. Although there is evidence of this link, we don’t really understand how Benzodiazepine use could lead to an increased risk of Alzheimer’s disease. Many more studies are needed to understand the correlation between the two.

Benzodiazepines are widely used for the treatment of anxiety and insomnia, however, the existing guidelines for doctors indicate that they should only be used for short periods of time. The BMJ study also indicates that short term use of the medications were not linked to Alzheimer’s and that only prolonged use was correlated with the disease. In conclusion, I believe that this study is another strong re-enforcement for us doctors to remember the guidelines, and to not use Benzodiazepines for long periods.

If you are on a Benzodiazepine, talk to your doctor about alternatives to this medication.

Doctor Life Advice

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Sayeh Beheshti, M.D.

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