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Dr. Bob is Robert Hsiung, MD,
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Posted by herpills on September 10, 2014, at 9:57:06
Drugs used for anxiety, sleep are linked to Alzheimer's disease in older peopleAlzheimer's disease appears to be more likely in those who have intensively taken a class of drugs, benzodiazepines, widely used to treat insomnia and anxiety, says a new study. (Los Angeles Times)
By Melissa HealyMedications used to tame anxiety and bring sleep can erode mental function, may make Alzheimer's more likely.
Insomniacs routinely use benzodiazepines for more than the recommended three months
Xanax, Valium and Ativan mellow you out, but at a potential cost.Older people who have relied on a class of drugs called benzodiazepines to reduce anxiety or induce sleep are at higher risk of going on to develop Alzheimer's disease, new research finds, with those whose use of the medications is most intensive almost twice as likely to develop the mind-robbing disorder.
Melissa Healy
Benzodiazepines -- marketed under such names as as Xanax, Valium, Ativan and Klonopin -- are widely used to treat insomnia, agitation and anxiety, all of which can be early signs of impending Alzheimer's disease in the elderly. But the current study sought to disentangle benzodiazepines' use in treating early dementia symptoms, probing instead the possibility that heavy use of the medications may permit, cause or hasten the onset of Alzheimer's dementia.
The study compared the pattern of benzodiazepine use in 1,796 people elderly people diagnosed with Alzheimer's with that of 7,184 similar people who had no such diagnosis. Such a study design, conducted by French and Canadian researchers and published Tuesday in the journal BMJ, cannot by itself establish that more intensive use of the medications causes Alzheimer's disease. But it does strengthen such suspicions.
lRelated Learning a second language at any age may slow the brain's declineAmong the study participants over 66 who were living independently in the Canadian province of Quebec, those who took low-dose benzodiazepine medication, or who took higher doses but very briefly or infrequently, did not see their Alzheimer's risk go up five years after they were first prescribed such a medication. But the picture was more worrisome for those who frequently took long-acting benzodiazepines, who frequently took high doses, or who took any such drugs regularly over several months.
The benzodiazepines specifically considered by the researchers were the short-acting anti-anxiety medications alprazolam (Xanax), lorazepam (Ativan), oxazepam (Seresta) and diazepam (Valium), and the longer-acting anti-seizure and "hypnotic" drugs frequently used to treat insomnia: clonazepam (Klonopin), flurazepam (Dalmane), midazolam (Versed), nitrazepam (Mogadon), temazepam (Restoril) and triazolam (Halcion).
The widely prescribed prescribed medicines marketed as Ambien, Lunesta and Sonata (generically named zolpidem, eszopiclone and zaleplon) are "atypical benzodiazepines" and were not included in the analysis.
cCommentsThe authors of the study created an index that gauged the intensity of a participant's benzodiazepine use and found that at the end of a five-year period following an initial prescription, Alzheimer's risk mounted steadily. 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 none to develop Alzheimer's. Those who took the cumulative equivalent of a full daily dose for more than six months were 84% more likely to do so.
There's already strong research evidence that frequent or regular benzodiazepine use degrades memory and mental performance in humans and animals. And some research suggests that with regular use of this class of drugs, the receptors to which they bind in the brain become less active. And lower activity of those receptors has been linked to cognitive decline.
"In view of the evidence, it is now crucial to encourage physicians to carefully balance the risks and benefits when initiating or renewing a treatment with benzodiazepines and related products in older patients," the authors wrote.
International medical guidelines recommend the use of benzodiazepines as treatment for anxiety disorders and transcient insomnia, but caution that they are not meant for long-term use, and should not be taken steadily for more than three months. But many patients continue to take these drugs for years. In addition to their cognitive effects, benzodiazepines are widely implicated in the national epidemic of opioid pain medication overdoses and fatalities that result from mixing them with alcohol and opioid drugs.
Posted by SLS on September 10, 2014, at 12:59:36
In reply to new study says benzos increase risk of alzheimers, posted by herpills on September 10, 2014, at 9:57:06
Could you post the URL link where you found this article?
Thanks.
- Scott
Posted by Fred23 on September 10, 2014, at 13:01:05
In reply to new study says benzos increase risk of alzheimers, posted by herpills on September 10, 2014, at 9:57:06
If it weren't for the benzos, the cortisol would do more damage.
Posted by Phillipa on September 10, 2014, at 15:51:45
In reply to Re: new study says benzos increase risk of alzheimers, posted by Fred23 on September 10, 2014, at 13:01:05
I have read some of the studies and most say key is older adults with demetia. And also HIgh doses. Do I count? 44 years on low doses and at age 68 I'm fine. Phillipa
Posted by Phillipa on September 10, 2014, at 18:12:26
In reply to Re: new study says benzos increase risk of alzheimers, posted by Phillipa on September 10, 2014, at 15:51:45
Posted by Phillipa on September 10, 2014, at 18:21:22
In reply to Re: new study says benzos increase risk of alzheimers, posted by Phillipa on September 10, 2014, at 18:12:26
Posted by SLS on September 11, 2014, at 7:25:26
In reply to Re: new study says benzos increase risk of alzheimers » herpills, posted by SLS on September 10, 2014, at 12:59:36
> Could you post the URL link where you found this article?
>
> Thanks.
>
>
> - Scott
http://www.bmj.com/content/349/bmj.g5205
- Scott
Posted by Phillipa on September 11, 2014, at 9:30:54
In reply to Re: new study says benzos increase risk of alzheimers, posted by SLS on September 11, 2014, at 7:25:26
Scott so since you are so good at interpreting results of studies what is your conclusion of taking low doses of benzos for many years with a family history of anxiety disorder. Thanks Phillipa
Posted by linkadge on September 11, 2014, at 17:24:40
In reply to Re: new study says benzos increase risk of alzheimers » SLS, posted by Phillipa on September 11, 2014, at 9:30:54
The study suggests that long term use of high dose benzodiazepines is associated with an increased risk of developing Alzheimer's.
Lower doses used for shorter periods of time were not associated with alzheimers.
The big issue for me is the fact that elderly who require large doses of benzodiazepines may already be at elevated risk. I don't know if this risk can be fully accounted for.
Anxiety and agitation in elderly is an early sign of alzheimers. Can they really control for the risk associated with individuals whose anxiety is severe enough to warrant high doses?
If benzos are the only thing that works, take them. But if you can keep the dose as low as possible with adjuncts like magnesium, niacin, etc. then do so.
Linkadge
Posted by linkadge on September 11, 2014, at 17:28:25
In reply to Re: new study says benzos increase risk of alzheimers, posted by linkadge on September 11, 2014, at 17:24:40
It may be too, that the doses used in the elderly are too high. An older individual might not be able to tell you that a benzo dose is too high. Retirement homes may welcome the fact that the patient sleeps all day and is more manageable.
It could be that excessive doses are more toxic than the right dose.
Its just like with epilepsy. Seizures are neurotoxic, but the anticonvulsants (in certain circumstances) can be neurotoxic too (especially if the dose is too high).
Linkadge
Posted by Phillipa on September 11, 2014, at 17:36:07
In reply to Re: new study says benzos increase risk of alzheimers, posted by linkadge on September 11, 2014, at 17:28:25
Link take magnesium citrate 200mg tabs from health food store at night. How would Niacin also help? I take .25mg of xanax X 2 at night & valium total 7.5mg per day. That is low isn't it. Or should I drop one and if so which one? Don't take any during the day.
When worked in nursing homes vita H was given IM till the patient was out cold then they slept for a few day. Wasn't nice to see. Phillipa
Posted by ed_uk2010 on September 12, 2014, at 13:30:58
In reply to Re: new study says benzos increase risk of alzheimers » linkadge, posted by Phillipa on September 11, 2014, at 17:36:07
>I take .25mg of xanax X 2 at night
& valium total 7.5mg per day. That is low isn't it.Hi PJ,
It's moderate rather than low. You could try this if your doc agrees:
Increase diazepam to 10mg per day and decrease Xanax to 0.25mg x 1 at night.
After a few weeks, you could then increase diazepam to about 12mg per day and stop Xanax.
At this stage, you're only on one benzo, diazepam, which is easier to taper.You can then consider reducing diazepam by about 1mg (half a 2mg tablet) every few weeks/months. There is absolutely no rush, and no benefit in rushing, but you might find that a few months later you're on a lower total daily dose. You may then notice an improvement in memory/cognition.
Ed
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