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Can Some Sleep Medications Raise the Risk of Alzheimer’s Disease?

Can Some Sleep Medications Raise the Risk of Alzheimer’s Disease?

Benzodiazepines are a class of drugs used to treat short-term insomnia, anxiety, and sometimes epilepsy. Although clinical guidelines recommend against the long-term use of benzodiazepines, particularly in elderly people with a greater risk of side effects, chronic benzodiazepine use is common in older populations.

A new study in the British Medical Journal (BMJ) reported that people who had used benzodiazepines for more than three months had almost a 50 percent higher risk of Alzheimer’s disease over the following six years, an association that has been reported previously. Short-term use of benzodiazepines (less than 91 daily doses) did not raise the risk for Alzheimer’s but, beyond that point, with longer use came greater risk. The associated risk was observed even in people who had previously used a benzodiazepine for at least six months but had stopped using it at least a year before their diagnosis of dementia.

It is not completely clear if the risk comes from benzodiazepines or from the health conditions for which benzodiazepines are regularly prescribed. Both anxiety and sleep disorders are potential risk factors for dementia. The scientists leading this study did attempt to control for these risk factors and still observed an increased risk from benzodiazepine use. Scientists do not yet know why benzodiazepines might accelerate the development of Alzheimer's disease. 

This study reinforces what most clinicians already know—benzodiazepines should not be the first line of treatment. When they are used, they should be used in the short-term only. All sleep medication, including zolpidem (Ambien™) can cause cognitive impairment including amnesia and should be used with caution in the elderly.

The benzodiazepine medications evaluated in the study were: 

  • Bromazepam (20 h)
  • Alprazolam (10-20 h)
  • Chlordiazepoxide (5-30 h)
  • Lorazepam (10-20 h)
  • Clobazam (20 h)
  • Oxazepam (8 h)
  • Diazepam (32-47 h)
  • Flurazepam (120-160 h)
  • Midazolam (1.5-2.5 h)
  • Nitrazepam (16-48 h)
  • Temazepam (5-8 h)
  • Triazolam (2 h)
  • Clonazepam (20-60 h)

Aaron Carman, PhD, was previously the Assistant Director of Aging and Alzheimer's Prevention at the Alzheimer's Drug Discovery Foundation. Dr. Carman received his doctorate in microbiology and molecular genetics from The University of Texas Health Science Center at Houston.

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