The People's Perspective on Medicine

Anti-Anxiety Drugs Raise the Risk of Alzheimers Disease

Benzodiazepine drugs used to allay anxiety may have a negative effect on brain power in the long term.

Are anti-anxiety agents and sleeping pills making us stupid? That is a question that is giving some scientists nightmares.

These are among the most prescribed drugs in America. Alprazolam (Xanax) is dispensed nearly 50 million times each year. Other popular benzodiazepine medications for anxiety and insomnia include clonazepam, diazepam, lorazepam and temazepam. A study published in the prestigious journal The BMJ (online, Sept. 10, 2014) found a link between this category of medications and an increased risk of developing Alzheimer’s disease. The investigators reported that older people who had taken such drugs for at least three months were 51 percent more likely to be diagnosed with Alzheimer’s disease. The longer they were on the medicines, the greater the risk.

Did the Alzheimer’s Disease Come First?

Critics have suggested that people who are developing early dementia may be anxious and have trouble sleeping. As a result, people most at risk might also be those who are likely to use these medications. The authors of the study point out that

“the association between Alzheimer’s disease and benzodiazepine use started at least five years before diagnosis was assessed.”

In addition, because the risk rises with longer use, it seems to point to benzodiazepines as contributors.

Getting Off Benzodiazepines

This news is disheartening for anyone over 50 taking one of these medications. No one wants to increase the chance of developing dementia, but stopping these drugs can be extremely challenging. People who suddenly stop taking their pills can suffer ferocious withdrawal symptoms.

One health professional shared this experience:

“I was a nurse for over 42 years, and I’m alarmed by the staggering increase in the use of anti-anxiety medications like alprazolam or diazepam. There’s no doubt in my mind that these addictive drugs change the way people think. I’ve observed poor logic, poor memory and impaired reasoning even before dementia sets in.

“Worse yet, these meds tend to come in very tiny pills, somehow making people think they are safer. It was very common to see withdrawal in patients who were hiding their overuse of these drugs, and the withdrawal was a frightening thing to watch. The resulting severe confusion, agitation and even hallucinations can last for days.”

Other symptoms of benzo withdrawal include anxiety, irritability, sensitivity to sound, light and touch, impaired concentration, panic, insomnia, faulty memory, depression, headache, sweating and muscle twitching.

Sleeping Pills Also Pose Problems

Related medications include “Z” drugs prescribed for insomnia (eszopiclone, zaleplon, zolpidem). These medicines resemble the benzodiazepines in affecting the neurotransmitter GABA–gamma aminobutyric acid.

What Should Doctors Do?

The scientists who reported a link between benzodiazepines and dementia suggest that it would be prudent for doctors to follow international prescribing guidelines and limit the use of such drugs to three months or less. Such short-term use does not appear to pose an excess risk of memory loss.

People concerned about these and other medicines that can cause confusion in older patients may be interested in our Guide to Drugs and Older People.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Jeez.. this is depressing news. I’m 61 and have been taking many of these drugs on and off my whole life! For the past 3 years have been taking .5mg xanax and 3mg Lunest every night to sleep. Now I have to ween myself off those. Plus I have a big jar of Bentyl that I take when IBS kicks in… and I’ve been taking those for over 20 years. Cumulative effect is very concerning!!!! At this point does it make a difference to stop now…or will dementia be approaching soon? ugh.

I do not see any empirical testing listed or actual data on the studies you claim. Why don’t you show where these studies were done and by whom and how many persons were tested and did they use a group using placebo’s to see if there were actual problems uncovered. All you do is talk about what someone has determined without giving us how this was arrived at. I take these medications and it is very disturbing to me to continue but your evidence is not sufficient. Cam S.

I have been taking ativan for 27 years…yes 27. Recently…last month…the pharmacy would not refill my medication…for two weeks. There are new laws that are in place that make it impossible for pharmacies to refill any of this sooner. In any case, I was in a mess. I had to then go and get a prescription for xanax…because I would have been in drug rehab. I had a surgery two years ago (that just went horribly) and I have medical bills exceeding 10 grand. So, I do want to get off all this stuff…and why in the world do they prescribe them???? If they are bad…then there should be laws against this stuff. What is the medical profession thinking?

Has there been any further supporting research relative to this issue and the 2014 Study? I originally inquired at the top of this thread abt use of diazepam for a lot of years for situational/performance anxiety – I am 57 and a performer. I would appreciate any updates/perspective per my initial post in this thread, as this has raised a serious concern for me. Thanks, mike in mich

Another thing to worry about. Have taken Diazepam as-needed for 30 years . 5mg… for performance anxiety – not necessarily ‘daily’ – just for situational – never recreational use. I am 56. Should I assume that I am at a substantially higher risk for Alzheimers? Is a less-long-acting type of benzodiazepene like Xanax is said to be – possibly a wiser med – and is it as effective for short-term – fast-acting anxiety relief? This is a disturbing piece of news – I was led to it based on the news about anticholinergic (benadryl etc) drugs out this week from the one study… I also note that the findings on benzos and any connection to dementia do not SEEM to be overwhelming or based on a huge database of research – Would greatly appreciate other perspectives on this.

Thanks!

Mike in Mich

My husband passed away from Lewy Body Disease. He was not on any medications before being diagnosed with LBD. As far as I know there is no known cause for LBD.

Another thing overlooked in people with anxiety and depression and sleep problems is that they have sleep apnea. Anxiety and depression run in my husbands family. My husband was diagnosed with sleep apnea when he was around 60 (now he is 72) We found this out through a friend in her 80’s whose husband had similar symptoms (not the doctors we were seeing for all his complaints.) Once suggested to the doctor he said let’s try it. My husband always gasped for air, was fitful and was taking lots of naps during the day, etc, plus asthma/allergies worsened, and he gained weight so easily too. Long story short, he had a sleep test and showed he stopped breathing at night 50 times in one hour. No wonder his problems. Look up sleep apnea and symptoms. Then he noticed all the similar symptoms his brothers have had when visiting them all (they live in different states). His oldest brother has always been a fitful sleeper violently thrashing about (he and wife sleep in twin beds because of that) but not a big nap taker. He’s been taking anti depressants for years. He has had a-fib for years and recently has had serious procedures and blood thinners for that. A common result from sleep apnea. The other one who has just diagnosed with lewy body dementia has always gasped for air. So it seems that doctors should always give sleep studies to people, not just prescribe sleeping pills. The studies now can be given in your own bed with a wire from a machine clipped (like clothes pin to your finger.) My husband has been using a cpap machine for the last 11 years. Also our new doctor found my husband was very low in vitamin D (check out the symptoms for that) and that has seemed to help immensely. His oldest brother’s doctor recently prescribed that too.

my husband’s brother 68 years old has been battling depression, then diagnosed with bipolar for years, seeing psychiatrists who prescribed so many different drugs that only worked partially or over drugged him and now has finally been diagnosed with lewy body dementia. The drugs he was given over the years we find out has caused this. The last few years have been very hard on the family as well as him. No wonder he kept getting worse in his demeanor and behavior.

I have a friend who is addicted to Xanax [alprazolam]. She has been to drug treatment centers 3 times to try and get off of it, but can’t bear the symptoms involved with withdrawal long enough to get over that hump and goes home before she completes the program.

I have known her over 24 years and she has in fact become less able to function and be involved socially. She wishes she had never taken this drug. There are certainly other anti-anxiety meds that don’t lead to such severe addiction as Xanax. Why don’t Drs. prescribe these instead?

I have recently tapered off Ambien. Now for beginning of a much slower, painstaking taper off Clonazepam. Having been on this drug at 1.5mg at bedtime for 3 years, it will need be slow and gradual. I forecast that much like we saw with Ambien, that only 3months, or a 90 day supply of these drugs allowed in many drug formularies beginning in 2015, the same will occur with these Benzodiazepines. After having been through a Benzo withdrawal in the past, I can say first hand it can make one quite sick.

I have partnered with my Psych Doc to begin this withdrawal at .125mg at a time. Will be doing this at my own tolerance and pace, but always with my eye on the goal of being completely off. While I feel my ticket has already been punched, so to speak, on the risk of early Dementia, it is nonetheless a worthwhile thing to do, as well as being proactive against the day when drastic decreases to availability, and coverage by Insurance Companies will likely become reality. Would rather it be on my own terms, than theirs.

I use xanax for sleep; before that it was valium. I discovered they help me sleep when I was given the valium for a painful shoulder, to help relax the muscles. However, here they prefer xanax. I first took valium about forty years ago. BUT, I use this medication very responsibly, never taking more than 5mg a week, most times a lot less. I alternate them with zolpidem, so even after all these years, 25 on the xanax, 18 on valium, they still work. It is only when I have a lot of pain and will not be able to sleep, or after two or three miserable nights, or even one night after lying awake for up to two hours, that I use one of these medications. I do not notice extra wooziness, nor forgetfulness the next day. I appreciate falling asleep quickly and staying asleep thru the night. There are no urges to continue use, such as daily, after a single night’s dose.

I have been taking lorazepam (Ativan) for the past 17 years and I will be 70 in 13 days. I have not noticed any cognitive impairment at all and neither have my close friends and family. I do experience occasional amnesia; for example, if I watch a movie at night after taking a lorazepam I may not remember it well. I take 2 mg tablets two to three times a day and more on days when I am very stressed or anxious. I highly value this medication as I have a sleep disorder and it helps me sleep well through the night. I also have an anxiety disorder and lorazepam has kept me from having to be hospitalized during times of extreme anxiety states. I think my mind is as sharp as ever and I can think circles around most people my age. My mother (passed away 2010) developed dementia in her mid-nineties and lorazepam was very helpful to her. She took it on an “as needed” basis and it enabled her to leave the house for doctors’ appointments or to go out for dinner without anxiety. By the way, before she developed anxiety with her dementia, she had never taken lorazepam. I’m a great fan of this medication and have no intention of trying to stop taking it, despite the current research. It gives me a quality of life I would not have otherwise.

Love your program. I do take issue thouģh with your question asking if certain medications are making us stupid. You imply that alzheimer patients are stupid. They are ill and their illness perhaps is caused by medication but please do not call them stupid. Very insensitivè.

I would like to hear more about this subject as I take clonazepam.

Read this about Xanax

Xanax directly contributed to my sister’s suicide in 2001. Her husband’s cardiologist (without performing a history and physical examination) prescribed Xanax to her, primarily because he was tired of her anxiety and numerous questions about her husband’s condition. She immediately became dependent on it, and her personal physician continued the prescription for a time and then abruptly stopped prescribing it without gradually withdrawing it. She went through a nightmare of withdrawal symptoms, was hospitalized in an actively suicidal state, and then allowed to sign herself out of the hospital against medical advice. Her first act upon being discharged was to visit a gun store to apply for the purchase of a handgun. Two days later she was dead. Benzodiazepines are extremely dangerous, but are commonly prescribed by physicians who have virtually no training in psychiatry or the proper use of psychoactive medications. My personal opinion is that their use should be restricted, and only those physicians who have proper training in their use should be allowed to prescribe them.

I am a nurse who has worked extensively with the elderly in NH and ALFs for over 15 yrs. The focus studies should be more concentrated on the over medication of the elderly with pain meds, double amts of blood pressure meds, diuretics, sleep medications etc. Some take over 50 different meds a day, and most have no idea what they are for, what they do, or what side effects are.-Put the focus where it is needed most. Overmedication with all drugs to elderly. Especially the pain drugs.

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