Long-term Use of Anxiolytics Linked to Alzheimer's Disease, Study Suggests

While previous research has shown a link between benzodiazepines and acute cognitive function, a link between the anxiolytic medicines and an increased risk for certain neurocognitive disorders remains unclear. A team of researchers from France and Canada conducted a study to investigate the relationship between the risk of Alzheimer's disease (AD) and long-term exposure to benzodiazepines, as well as a potential dose-response relationship in 1,796 people—aged 66 and older—with a first diagnosis for AD and 7,184 age-matched healthy controls. The study analyzed participant’s prescription and medical records dating back six years prior to diagnosis.

The results, published in BMJ, showed that past use of benzodiazepines for three months or more was associated with an increased risk—up to 51%—for AD. The association increased even more with longer exposure to the anxiolytic. In addition, the use of long-acting forms of benzodiazepines increased risk for AD by 19 percent more than that of the short-acting. Results were sustained after adjusting for anxiety, depression, and sleep disorders.

“Benzodiazepines are known to be associated with an increased risk of worsening cognition…even in cognitively normal elderly subjects,” said Davangere Devanand, M.D., director of the geriatric psychiatry program at Columbia University, in an interview with Psychiatric News. “This cognitive worsening may lead to diagnosis of Alzheimer’s disease as described in this study. In such situation, tapering and stopping the benzodiazepine and then re-evaluating the patient’s cognition can be helpful in clarifying the diagnosis. If the cognitive decline is due to benzodiazepines and the patient does not have an underlying dementia such as Alzheimer’s disease, the cognitive decline should reverse after stopping the treatment. Prescribers should use benzodiazepines sparingly…because of their known adverse effects.”

To read more about adverse effects associated with the use of benzodiazepines and other psychoactive drugs, see the Psychiatric News articles “Benzodiazepines May Raise Dementia Risk” and “Risk-Benefit Analyses in Medication Decision Making.” 

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