Valium and Xanax Increase Risk of Dementia
Popular anti-anxiety drugs Valium and Xanax are linked with an increased risk of dementia in seniors, according to new research.
Patients over the age of 65 who start taking the drugs known as benzodiazepines, and also used to treat insomnia, have a 50% increased chance of developing dementia within 15 years compared with people who had never used the drug, according to the study.
Researchers from the University of Bordeaux, France, warned that “indiscriminate widespread use” of the drugs should be cautioned against.
Benzodiazepine is a widely prescribed drug for seniors in many countries: 30% of this age group in France, 20% in Canada and Spain, 15% in Australia. Although less widespread in the UK and US it is still very widely used and many individuals take this drug for years despite guidelines suggesting it should be limited to a few weeks.
The research examined 1063 people with an average age of 78 over two decades. They had never taken the drug before and were all free from dementia.
The study started in 1987. The researchers used the first 5 years to identify the factors leading to benzodiazepine initiation and evaluated then the association between new use of this drug and the development of dementia. They also assessed the association between further benzodiazepine initiation during the follow-up period and risk of dementia.
Rates were adjusted for many factors potentially affecting dementia, such as age, gender, educational level, marital status, wine consumption, diabetes, high blood pressure, cognitive decline, and depressive symptoms.
95 out of the 1063 patients started taking benzodiazepine during the study. After a 15-year follow-up 253 (23.8%) cases of dementia were confirmed, 30 in benzodiazepine users and 223 in non-users. Of these, 30 had begun to take the drugs between three and five years into the study. New initiation of the drug was associated with shorter dementia-free survival.
The chance of dementia occurring in those who had taken the drugs was 4.8 per 100 “person years” – a statistical measure representing one person at risk of development of a disease during a period of one year.
Of those who had not taken the drugs the likelihood was measured to be 3.2 per 100 person years, the researchers found.
“In this large, prospective, population based study of elderly people who were free of dementia and did not use benzodiazepines until at least the third year of follow-up, new use of benzodiazepines was associated with a significant, approximately 50% increase in the risk of dementia,” the authors wrote.
“Benzodiazepines remain useful for the treatment of acute anxiety states and transient insomnia. However, increasing evidence shows that their use may induce adverse outcomes, mainly in elderly people, such as serious falls and fall related fractures.”
“Our data add to the accumulating evidence that use of benzodiazepines is associated with increased risk of dementia, which, given the high and often chronic consumption of these drugs in many countries, would constitute a substantial public health concern.
“Therefore, physicians should carefully assess the expected benefits of the use of benzodiazepines in the light of these adverse effects and, whenever possible, limit prescription to a few weeks as recommended by the good practice guidelines.
“In particular, uncontrolled chronic use of benzodiazepines in elderly people should be cautioned against.”
Dr Eric Karran, director of research at Alzheimer’s Research UK, added: “Long-term population studies are invaluable for helping us to understand how our environment and life events may influence our risk of dementia, but it can be incredibly difficult to tease out the real cause behind these associations.
“It could be the underlying conditions that drive someone to need benzodiazepines, rather than the drugs themselves, that are the important risk factors in this case.”
“While more research is needed to understand why benzodiazepines may be associated with an increased risk of dementia, the study does highlight the importance of careful drug prescription.”
This research was published on bmj.com.[hr]