Benzodiazepines are a class of drugs often prescribed to ease the anxiety and/or the insomnia associated with chronic pain. They include familiar names such as Xanax, Valium, Ativan and Klonopin. Unfortunately, recently published research has found that older patients prescribed these drugs are at a higher risk of developing Alzheimer’s disease, the risk becoming significantly higher with the greater use of these medications.
Interestingly, many of these drugs are used to treat elderly patients suffering from agitation and anxiety—symptoms which can themselves be early manifestations of what could eventually be Alzheimer’s dementia. Researchers set out to study the intriguing hypothesis that perhaps these drugs were not so much treating anxious patients, but instead creating demented patients.
The study, as described in last month’s issue of the “British Medical Journal,” compared the pattern of benzodiazepine use in 1,796 elderly people diagnosed with Alzheimer's disease with that of 7,184 similar people who had no such diagnosis. Obviously, this sort of observational study design cannot definitively establish that more intensive use of benzodiazepines causes Alzheimer's disease. Nevertheless, it raises interesting issues that need to be explored with a more robust scientific method.
The study participants were individuals over 66 years of age. Those who took low-dose benzodiazepines, or who took only occasional high dosages, did not have their Alzheimer's risk increase for the five years they were studied after having been initiated on these agents. In contrast, those who frequently took long-acting benzodiazepines, who frequently took high doses, or who took any such drugs regularly over several months, suffered a more disturbing fate: Specifically, those who took the cumulative equivalent of daily doses for three to six months over a five-year period were roughly 32% more likely than those who took no benzodiazepines to develop Alzheimer's. And those who took the cumulative equivalent of a full daily dose for more than six months were 84% more likely to do so.
It is already acknowledged by the thought leaders in the medical community that benzodiazepines are not meant for long-term use, and should not be taken steadily for more than three months. But a glance at the refill patterns of most patients reveals that these drugs are used on a chronic basis, for years and years. In addition to their cognitive adverse effects, benzodiazepines are also implicated in the national epidemic of opioid pain medication overdoses and fatalities that result from mixing them with alcohol and opioid drugs.
A nice cup of chamomile tea is sounding pretty good right about now.