A new study has shown that popular anti-anxiety and sleep medications like alprazolam (Xanax) and zolpidem (Ambien) are linked to an increased risk of developing Alzheimer’s disease later in life.
According to a study published in the September 9, 2014 issue of the British Medical Journal, long-term use of benzodiazepines increased the risk of developing Alzheimer’s disease by about 50 percent among a group of elderly people. The greater and longer dose, the higher the risk.
Benzodiazepines are a class of drugs that have sedative and hypnotic effects, and are typically prescribed for anxiety and insomnia. They’re also used to treat agitation, seizures, muscle spasms and alcohol withdrawal. Included in this group of prescription medications are the anti-anxiety drugs lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), and clonazepam (Klonopin) and the sleep medications zolpidem (Ambien) and eszopiclone (Lunesta).
Benzodiazepines can be dangerous if taken longer than necessary. In fact, many people develop a dependency and become chronic users as their tolerance increases. Benzodiazepines are known to exacerbate the symptoms of anxiety and insomnia with long-term use, which can lead to severe withdrawal syndrome. Several studies have shown that the use of benzodiazepines could be a risk factor for developing dementia later in life.
Long-Term Benzodiazepine Use Boosts Alzheimer’s Risk
In another study, a team of researchers at the Université de Bordeaux in France randomly selected patients over 66 years old with Alzheimer’s disease and without the disease and compared their drug prescriptions during the years just prior to the patients showing signs of Alzheimer’s disease. It was found that those who’d taken a benzodiazepine for three months or less had about the same risk of developing Alzheimer’s disease as those who’d never taken this type of drug. However, taking a benzodiazepine for three to six months increased the risk of Alzheimer’s disease by 32 percent, and taking a benzodiazepine for more than six months increased this risk by 84 percent.
Longer-acting drugs in this class, such as diazepam (Valium), put people at a greater risk for Alzheimer’s disease than short-acting medications like lorazepam (Ativan) and alprazolam (Xanax) do. The researchers also found that the cumulative dose mattered: As long as people stopped at 90 doses over the course of treatment, their risk remained the same as if they’d never taken the drug.
The Link Between Sedative Use and Symptoms of Alzheimer’s Disease
While correlation doesn’t imply causation, outside scientists commented on the methodical study design that was meant to rule out the possibility that people were simply more prone to take benzodiazepines because they were already suffering from the early symptoms of Alzheimer’s disease. These symptoms can include anxiety, sleeplessness and agitation. The French study looked at people with Alzheimer’s disease who hadn’t taken benzodiazepines for five years before the study.
“The stronger association observed for long-term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia,” the authors wrote. “Unwarranted long-term use of these drugs should be considered as a public health concern.”
Elderly people are especially at risk when taking benzodiazepines. In 2012, the American Geriatrics Society put benzodiazepines on the Beers List, which is a list of medications that shouldn’t be used to treat people over the age of 65. These medications can make symptoms worse in older people. In the case of benzodiazepines, treatment for sleeplessness or insomnia inadvertently leads to an increased risk of falls, fractures and car accidents.
Benzodiazepines for Addiction Recovery
Addiction recovery specialists often need to treat insomnia and anxiety in early sobriety. Many don’t immediately choose benzodiazepines for these symptoms due to the risks they carry. Other medications with sedative effects are available, such as diphenhydramine (Benadryl) and trazodone (Desyrel).
These specialists are also familiar with the addictive quality of benzodiazepines as well as what’s called benzodiazepine withdrawal syndrome. Withdrawal from these drugs, even if done properly with a medically-informed taper regimen, can come with its own host of unpleasant side effects, including anxiety, depression, insomnia, sensory and motor disturbances, and poor memory and cognition. A slow, gradual reduction in a benzodiazepine dose can help users avoid a “protracted” withdrawal syndrome in which the symptoms come and go for months and sometimes years.
Joseph Lee, MD, medical director at Hazelden Youth Continuum in Center City, Minn., says that benzodiazepines can be used short-term to treat alcohol withdrawal, but that other medications called anticonvulsants can also be used without the fear that the addicted person will become dependent on the drug. “Anticonvulsants seem to help, and studies show that some of these drugs work better than benzodiazepines do,” Dr. Lee says. “It’s best to not take chances.”