{"title":"Benzodiazepines: dementia in the elderly?.","authors":"","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>About twenty benzodiazepines and related drugs, such as zolpidem and zopiclone, are used to treat sleep dis- orders and anxiety, and also as anti- convulsants.Their short-term adverse effects include confusion and cogni- tive disorders that regress only slow- ly after treatment withdrawal, especial- ly in elderly patients. Questions have been raised as to persistent cognitive effects in case of long-term benzo- diazepine exposure. A case-control study of 1796 patients over 66 years of age showed that benzodiazepine exposure 5 to 10 years previously was statistically significant- ly more frequent among those who developed Alzheimer's disease. Five other epidemiological studies provided similar results. However, some studies showed no relation with the duration of exposure or the cumu- lative dose; this is an argument against a causal relationship between benzodiazepine use and dementia. These studies provide only weak evidence and thus fail to establish a causal relationship. In addition, early symptoms of dementia can cause anx- iety, which may lead to benzodiazepine prescription in the period preceding diagnosis.The results of these studies do not, however, rule out a long-term risk of persistent cognitive impair- ment. In practice, the known adverse effects of benzodiazepines are a suf- ficient reason to avoid these drugs, especially in elderly patients. The pos- sibility of irreversible cognitive impair- ment is another reason not to pre- scribe them.</p>","PeriodicalId":35983,"journal":{"name":"Prescrire International","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prescrire International","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
About twenty benzodiazepines and related drugs, such as zolpidem and zopiclone, are used to treat sleep dis- orders and anxiety, and also as anti- convulsants.Their short-term adverse effects include confusion and cogni- tive disorders that regress only slow- ly after treatment withdrawal, especial- ly in elderly patients. Questions have been raised as to persistent cognitive effects in case of long-term benzo- diazepine exposure. A case-control study of 1796 patients over 66 years of age showed that benzodiazepine exposure 5 to 10 years previously was statistically significant- ly more frequent among those who developed Alzheimer's disease. Five other epidemiological studies provided similar results. However, some studies showed no relation with the duration of exposure or the cumu- lative dose; this is an argument against a causal relationship between benzodiazepine use and dementia. These studies provide only weak evidence and thus fail to establish a causal relationship. In addition, early symptoms of dementia can cause anx- iety, which may lead to benzodiazepine prescription in the period preceding diagnosis.The results of these studies do not, however, rule out a long-term risk of persistent cognitive impair- ment. In practice, the known adverse effects of benzodiazepines are a suf- ficient reason to avoid these drugs, especially in elderly patients. The pos- sibility of irreversible cognitive impair- ment is another reason not to pre- scribe them.