Benzodiazepine medications ineffective for anxiety disorder but may increase dementia risk and risk of falls, injuries, accidental overdose, and death especially among those 65 and older
OCTOBER 5, 2015
New research by Helene Alphonso, DO, Director of Osteopathic Medical Education at North Texas University Health Science Center, found that benzodiazepines are relatively ineffective in treating anxiety disorder but may increase dementia risk and risk of falls, injuries, accidental overdose, and death especially among those 65 and older.
Patients taking benzodiazepines to treat psychiatric conditions should consider transitioning to other therapies because of heightened risks for dementia and death, according to the clinicians from the American College of Osteopathic Neurologists and Psychiatrists.
"Current research is extremely clear and physicians need to partner with their patients to move them into therapies…that are proven to be safer and more effective," said Dr. Alphonso, a board-certified psychiatrist practicing in Fort Worth. "Due to a shortage of mental health professionals in rural and underserved areas, we see primary care physicians using this class of drugs to give relief to their patients with psychiatric symptoms. While compassionate, it's important to understand that a better long-term strategy is needed."
A Canadian review of 9,000 patients found those who had taken a benzodiazepine for three months or less had about the same dementia risk as those who had never taken one. Taking the drug for three to six months raised the risk of developing Alzheimer's by 32 percent, and taking it for more than six months boosted the risk by 84 percent. Similar results were found by French researchers studying more than 1,000 elderly patients.
The case for limiting the use of benzodiazepines is particularly strong for patients 65 and older, who are more susceptible to falls, injuries, accidental overdose and death when taking the drugs. The American Geriatric Society in 2012 labeled the drugs "inappropriate" for treating insomnia, agitation or delirium because of those risks.
"It's imperative to transition older patients because we're seeing a very strong correlation between use of benzodiazepines and development of Alzheimer's disease and other dementias. While correlation certainly isn't causation, there's ample reason to avoid this class of drugs as a first-line therapy," Dr. Alphonso said.
Common benzodiazepine medications include Valium, Clonazepam, Diazepam, Alprazolam, Librium, Ativan, Tranxene, Serax, Halcion, Lorazepam, Restoril, Klonopin and Xanax.
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Authors: Jim Folk, Marilyn Folk, BScN. Last updated October 2015.