Benzodiazepines and Alzheimer

Use of benzodiazepines to treat insomnia or anxiety may increase the risk for Alzheimer's disease (AD), new research suggests.

Dr. Sophie Billioti de Gage

A case-control study of nearly 9000 older individuals showed that risk for AD was increased by 43% to 51% in those who had "ever used" benzodiazepines in the previous 5 years.

The association was even stronger in participants who had been prescribed benzodiazepines for 6 months or longer ― and in those who used long-acting versions of the medications.

Lead author Sophie Billioti de Gage, PharmD, who is also a PhD student and researcher at INSERM Unit 657–Pharmacoepidemiology at the University of Bordeaux, France, toldMedscape Medical News that the overall results were not a surprise because the short-term deleterious effects of these medications on memory are well documented. A study published by the same researchers last year showed a 50% increased risk for dementia in patients using benzodiazepines.

"The nature of the link (causal or not) is still not definitive, but these conclusions reinforce the suspicion of a possible direct association," said Dr. Billioti de Gage.

The investigators note that although these medications are important treatment options, clinicians should "comply with good practice guidelines" and prescribe benzodiazepines for as short a time as possible. In addition, use should not exceed 3 months.

"For people needing or using benzodiazepines, it seems crucial to encourage physicians to carefully balance the benefits and risks when initiating or renewing a treatment," added Dr. Billioti de Gage.

The study was published online September 9 in BMJ.

Public Health Implications

The researchers examined data from the Quebec, Canada, health insurance program database for 1796 individuals with a first diagnosis of AD who were older than 66 years (67% women) and who had exposure to benzodiazepines at least 5 years prior.

These patients were compared with 7184 sex- and age-matched healthy individuals; 6-year follow-up data were assessed for all participants.

Cumulative use of the medications was grouped into 3 subcategories of prescribed daily doses: 1 to 90, 91 to 180, and more than 180.

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