Americans love benzodiazepines (aka benzos). These anti-anxiety agents are used as all-purpose psych drugs. Millions of people take benzos to calm jittery nerves, ease anxiety and overcome insomnia. They include alprazolam, chlordiazepoxide, clonazepam, diazepam, lorazepam. The generic names are not as familiar as the brands: Xanax, Librium, Klonopin, Valium and Ativan. But despite their widespread popularity, these medications have side effects. And they’re hard to stop. Could taking a benzo, especially over the long run, raise your risk for Alzheimer Disease?
Mother’s Little Helper:
During the 1960s and 1970s, benzodiazepines were incredibly popular. Drugs like Librium and Valium topped the hit parade of most prescribed drugs. The Rolling Stones alerted the public to the dangers of sedatives in its iconic song “Mothers Little Helper” in the 1966 album Aftermath.
Many people were convinced the yellow pills in the song were 5 mg Valiums. Another possibility was Miltown (meprobamate), which preceded benzos. One other possibility was Nembutal. This barbiturate (pentobarbital) was very popular in its day. By now, you get the picture. Americans have had a love affair with sedatives, anti-anxiety agents and tranquilizers for many decades. The Stones captured the culture with these lyrics:
- “Mother needs something today to calm her down
- And though she’s not really ill, there’s a little yellow pill
- She goes running for the shelter of a mother’s little helper
- And it helps her on her way, gets her through her busy day…”
Benzos and a Connection with Alzheimer Disease:
While many folks may welcome something to help them cope with their stressful situations, a study from Finland raised questions about the safety of this strategy (Acta Psychiatrica Scandinavica, Aug, 2018) .
The scientists reviewed the prescription drug use of people diagnosed with this condition between 2005 and 2011, a total of 70,719 men and women. They compared this to the medications used by healthy neighbors of a similar age and sex. There were 282,862 of these matched controls.
What they found was that people who used benzodiazepines for anxiety or sleep and even those who used Z-drugs such as zolpidem or zaleplon for sleep were 6 percent more likely to be diagnosed with Alzheimer disease. Although this increase was statistically significant, it is very modest. So many older people take these medicines, however, that the increase in risk is a concern.
Short-Acting Benzos and Z-Drugs:
Spanish researchers analyzed data from Catalonia between 2002 and 2015 (International Journal of Neuropsychopharmacology, April 19, 2022). Records for the Catalan Health Service had 83,138 people over 45 who took a benzodiazepine or a Z-drug during that time. As controls, 84,652 people of a similar age in the same database did not take any such drug. According to the analysis, people who took a short-acting benzo were 11 percent more likely to develop Alzheimer disease. Those using Z-drugs had a 20 percent greater risk. Long-term use appeared especially problematic.
Benzos and a Link to Alzheimer Disease | Old News!
These are not the first studies to reveal a connection between benzodiazepine use and dementia. A study published in the BMJ back in 2014 found that benzos could increase the risk of Alzheimer disease by nearly 50 percent, especially among long-term users.
The authors concluded:
“Benzodiazepine use is associated with an increased risk of Alzheimer’s disease…Unwarranted long term use of these drugs should be considered as a public health concern.”
They go on to say:
“Our findings are of major importance for public health, especially considering the prevalence and chronicity of benzodiazepine use in older people and the high and increasing incidence of dementia in developed countries.”
Other researchers have performed data analysis and concluded that benzodiazepine use is not linked to Alzheimer disease (BMJ, Feb. 2, 2016). But a recent review of previous research concluded that there is an association between benzodiazepine use and the development of dementia (Pharmacotherapy, Aug. 11, 2018).
The People’s Pharmacy Perspective:
Benzodiazepines and Z-drugs have their place. After a crisis or the loss of a loved one, some people need an anti-anxiety agent to help them cope or get some sleep. Such drugs can be helpful for short-term use. When weeks stretch into months and months stretch into years, such drugs pose problems. For one thing, they are very hard to stop.
People taking drugs like alprazolam or lorazepam often complain of withdrawal symptoms of they stop too suddenly. Older people may be especially susceptible to dizziness and falls while taking benzos. If there is an increased risk for Alzheimer disease, that is a double whammy. Learn more about this problem in our Guide to Drugs and Older People.
Researchers are learning that many things contribute to dementia. Our genes are one factor. If mom and dad had Alzheimer disease, our chances of experiencing cognitive decline are increased. Head injuries are another important factor. So is exposure to anticholinergic drugs.
Other chemicals and medications may also play a role in mental decline. There is growing evidence that benzos may be part of that process.
Share your own experience with benzodiazepines below in the comment section. Was stopping challenging? If so, how did you deal with the “discontinuation syndrome”?