Benzodiazepines linked to Alzheimers

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VikingGnome
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Benzodiazepines linked to Alzheimers

Post by VikingGnome » Wed Sep 17, 2014 10:21 pm

A recent scholarly article published in the Journal of Affective Disorders draws a frightening conclusion. 50% more Alzheimers in patients who took benzodiazepines than the regular population. Benzodiazepines are used for insomnia, anxiety disorders, mood disorders, and seizures. The study was based on a 20-year followup of over 8,000 patients in Canada. They were unable to determine if the length of time exposed to benzos made any difference. There are a large number of benzo equivalents but common ones are Xanax, librium, valium, Klonopin, Tranxene, Dalmane, Ativan, Restoril.

Many OSA patients have been prescribed a benzodiazepine to help with sleep before being diagnosed and when beginning CPAP treatment. So now we have a 50% greater chance of getting Alzheimers because of that exposure. Flip a coin if you have taken a benzo for any period of time. Will you develop Alzheimers?

One thing the study did question was whether the insomnia and anxiety that caused patients to be prescribed a benzodiazepine might be prodromal symptoms of development of Alzheimers rather than the drugs CAUSING it. Patients with Alzheimers have insomnia, anxiety and restlessness in addition to their memory problems. So the idea is that patients that have insomnia, anxiety, and restlessness may be showing very early signs of Alzheimers but are prescribed a benzo to control those symptoms. If that is true, they would get Alzheimers anyway and the drugs had no causal relationship.

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Re: Benzodiazepines linked to Alzheimers

Post by SleepyEyes21 » Wed Sep 17, 2014 11:35 pm

VikingGnome wrote:A recent scholarly article published in the Journal of Affective Disorders draws a frightening conclusion. 50% more Alzheimers in patients who took benzodiazepines than the regular population. Benzodiazepines are used for insomnia, anxiety disorders, mood disorders, and seizures. The study was based on a 20-year followup of over 8,000 patients in Canada. They were unable to determine if the length of time exposed to benzos made any difference. There are a large number of benzo equivalents but common ones are Xanax, librium, valium, Klonopin, Tranxene, Dalmane, Ativan, Restoril.

VikingGnome- can you please post a link for this study? I think it is wise to be careful when extrapolating, interpreting, and/ or generalizing information from any scientific study. Although you mention "over 8,000 patients" were used in this study, there are numerous other factors that could come into play with any results garnered. For example, what was the drop-out rate? What other medications or medical conditions did the participants have that could have contributed to developing Alzheimer's? Since research has shown there is a genetic link for this type of dementia, how many of the participants had a genetic predisposition for this? My point here is that any reputable study needs to have specific parameters and standard protocols that can be replicated and therefore, validated.

So now we have a 50% greater chance of getting Alzheimers because of that exposure. Flip a coin if you have taken a benzo for any period of time. Will you develop Alzheimers?

I think this is a gross overgeneralization of information; can you give factual evidence that backs this statement up?


One thing the study did question was whether the insomnia and anxiety that caused patients to be prescribed a benzodiazepine might be prodromal symptoms of development of Alzheimers rather than the drugs CAUSING it. Patients with Alzheimers have insomnia, anxiety and restlessness in addition to their memory problems. So the idea is that patients that have insomnia, anxiety, and restlessness may be showing very early signs of Alzheimers but are prescribed a benzo to control those symptoms. If that is true, they would get Alzheimers anyway and the drugs had no causal relationship.
Patients with depression and other mood disorders, thyroid disorders, menopause, diabetes, and a host of other medical conditions also exhibit symptoms of "insomnia, anxiety, restlessness, and memory problems." So the hypothesis that these particular symptoms may only be precursors to Alzheimer's is flawed. Can we see these symptoms in Alzheimer patients? Certainly - but we see it in other conditions, as well.
I think we should be cautious in believing in everything we read

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Re: Benzodiazepines linked to Alzheimers

Post by kaiasgram » Wed Sep 17, 2014 11:46 pm

So now we have a 50% greater chance of getting Alzheimers because of that exposure. Flip a coin if you have taken a benzo for any period of time. Will you develop Alzheimers?
No, this is a misunderstanding of the statistics. The fifty percent higher rate of benzo history among Alzheimer's patients than among non-Alzheimer's patients does not mean that you have a 50/50 chance of developing the condition if you have taken benzos. Let's not scare ourselves any more than is necessary !

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Re: Benzodiazepines linked to Alzheimers

Post by lazyCLEANER » Thu Sep 18, 2014 12:08 am

I tend to agree with SleepEyes. In fact, Alzheimers is often a misnomer itself. To know if someone positively had alzheimers or advanced dementia (for any number of reasons), takes an autopsy and examination of the brain. The best of doctors get the diagnosis right 90% time. So, I'd be wary of all these new claims about 'this or that' increases risk of alz. Everyone's got an angle on trying to make a buck. Even researchers. Just my opinion. My mother had advanced dementia for years before she died so I have seen my share of doctors and hospice nurses on this issue.

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Re: Benzodiazepines linked to Alzheimers

Post by ems » Thu Sep 18, 2014 1:01 am

SleepyEyes21 wrote:Patients with depression and other mood disorders, thyroid disorders, menopause, diabetes, and a host of other medical conditions also exhibit symptoms of "insomnia, anxiety, restlessness, and memory problems." So the hypothesis that these particular symptoms may only be precursors to Alzheimer's is flawed. Can we see these symptoms in Alzheimer patients? Certainly - but we see it in other conditions, as well.
I think we should be cautious in believing in everything we read
+1 I heard about this "study" on the news - and thought the same thing.
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Re: Benzodiazepines linked to Alzheimers

Post by 49er » Thu Sep 18, 2014 1:11 am

As this board knows, I am not the biggest fan of psych meds and believe they are way over prescribed. But I do agree with the other posts advising caution as so many things can cause Alzheimers.

And speaking of studies, what greatly frustrates me about the reporting of them is that without full access to them, it is really impossible to evaluate everything fairly. Even an abstract can be inaccurate as the full report ends up being alot different than what is reported initially.

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Re: Benzodiazepines linked to Alzheimers

Post by kaiasgram » Thu Sep 18, 2014 1:17 am

A little more on the interpretation and misinterpretation of statistics:

In a quick search I found a 2014 British Medical Journal article speaking to the same research question with similar results as VG describes in the JAD article. This excerpt from the article (source below) reports the percentage of long-term benzo users among the Alzheimer's and the non-Alzheimer's groups:
... long term use (that is, >180 PDDs* or cumulative exposure over six months) was markedly more common among people with Alzheimer’s disease (32.9%) than controls (21.8%).
*PDDs = prescribed daily doses

So 32.9% of Alzheimer's patients had a history of long-term benzo use, whereas 21.8% of people without Alzheimers had a history of long-term benzo use.

32.9 is 50% greater than 21.8.

This does not mean that a long-term benzo user has a 50% risk of developing Alzheimer's. It also does not mean that long-term benzo users have a 32.9% risk of developing Alzheimer's.

Article can be found here: http://www.bmj.com/content/349/bmj.g5205

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49er
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Re: Benzodiazepines linked to Alzheimers

Post by 49er » Thu Sep 18, 2014 1:29 am

Thanks, I will take a look.
kaiasgram wrote:In a very quick search I didn't spot the JAD article that VG mentioned but I did find a 2014 British Medical Journal article speaking to the same research question with the same results. This excerpt from the article (source below) reports the percentage of long-term benzo users among the Alzheimer's and the non-Alzheimer's groups:
... long term use (that is, >180 PDDs* or cumulative exposure over six months) was markedly more common among people with Alzheimer’s disease (32.9%) than controls (21.8%).
*PDDs = prescribed daily doses

So 32.9% of Alzheimer's patients had a history of long-term benzo use, whereas 21.8% of people without Alzheimers had a history of long-term benzo use.

32.9 is 50% greater than 21.8.

This does not mean that a long-term benzo user has a 50% risk of developing Alzheimer's. It also does not mean that long-term benzo users have a 32.9% risk of developing Alzheimer's.

Article can be found here: http://www.bmj.com/content/349/bmj.g5205

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Re: Benzodiazepines linked to Alzheimers

Post by kaiasgram » Thu Sep 18, 2014 1:48 am

VikingGnome, I just re-read your post where you said
50% more Alzheimers in patients who took benzodiazepines than the regular population.
Now I'm a little confused -- are you saying (or was the article saying) 50% more Alzheimer's among the benzo users, or 50% more benzo users in the Alzheimer's group? I'm curious since I looked at a BMJ article and not the JAD article you mentioned.
Do you have a link to the JAD article?

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Re: Benzodiazepines linked to Alzheimers

Post by archangle » Thu Sep 18, 2014 6:10 am

You've also got to watch the assumptions about cause and effect. It could be that people who are going to develop Alzheimer's have other medical conditions that need to be treated by benzodiazapines.

You might similarly find that a large percentage of the people who have their feet amputated have taken insulin. Diabetics tend to lose limbs.

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Re: Benzodiazepines linked to Alzheimers

Post by VikingGnome » Thu Sep 18, 2014 9:42 am

I didn't say CAUSED. I said LINKED. I was given a paper copy of the article. It is available online for purchase $36.95 from publisher. Sorry I can't scan and put it online as it is copyrighted.

Here's an article about it: http://www.viralglobalnews.com/health/b ... tia/17016/

http://www.health.harvard.edu/blog/benz ... 1409107397

http://www.medscape.com/viewarticle/831403

http://www.pharmaceutical-journal.com/n ... 61.article

http://alzheimersnewstoday.com/2014/09/ ... mers-risk/

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Re: Benzodiazepines linked to Alzheimers

Post by Sir NoddinOff » Thu Sep 18, 2014 10:24 am

This is a much needed and pointed discussion about benzos and the few recent studies. Thanks VG for broaching this topic. The other links you posted are helpful also.

As a side note, I wonder where Z-meds like Ambien (generic: zolpidem) and Lunesta fit into the big picture of Alzheimer's, since they also hook into many of the same upper GABA receptors in the brain and spine? I learned early on that I personally don't do very well handling the side-effects of Xanax, it tends to mess with my nervous system in frightening ways. But that's just me.

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Re: Benzodiazepines linked to Alzheimers

Post by VikingGnome » Thu Sep 18, 2014 10:37 am

ems wrote:
SleepyEyes21 wrote:Patients with depression and other mood disorders, thyroid disorders, menopause, diabetes, and a host of other medical conditions also exhibit symptoms of "insomnia, anxiety, restlessness, and memory problems." So the hypothesis that these particular symptoms may only be precursors to Alzheimer's is flawed. Can we see these symptoms in Alzheimer patients? Certainly - but we see it in other conditions, as well.
I think we should be cautious in believing in everything we read
+1 I heard about this "study" on the news - and thought the same thing.
Not my conclusions or interpretations. Here are quotes from Harvard Health:
http://www.health.harvard.edu/blog/benz ... 1409107397

"The researchers acknowledge that the use of benzodiazepines could be just a signal that people are trying to cope with anxiety and sleep disruption—two common symptoms of early Alzheimer’s disease. If that’s true, their use of a benzodiazepine may not be a factor in causing dementia but an indication it is already in progress."

"People 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%, and taking it for more than six months boosted the risk by 84%."

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Re: Benzodiazepines linked to Alzheimers

Post by kaiasgram » Thu Sep 18, 2014 1:17 pm

VikingGnome wrote: I was given a paper copy of the article. It is available online for purchase $36.95 from publisher. Sorry I can't scan and put it online as it is copyrighted.

Here's an article about it: http://www.viralglobalnews.com/health/b ... tia/17016/

http://www.health.harvard.edu/blog/benz ... 1409107397

http://www.medscape.com/viewarticle/831403

http://www.pharmaceutical-journal.com/n ... 61.article

http://alzheimersnewstoday.com/2014/09/ ... mers-risk/
VG, all these links point to articles about the British Medical Journal study that I linked directly to in my earlier post. Can you post or PM me the citation info for the Journal of Affective Disorders study that you have a paper copy of? No need to scan it or anything, I would just need to know the volume number (and issue number if there is one) and year. I do have access to many online journals and would be interested to take a look at it.

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Re: Benzodiazepines linked to Alzheimers

Post by archangle » Thu Sep 18, 2014 4:24 pm

VikingGnome wrote:I didn't say CAUSED. I said LINKED. I was given a paper copy of the article. It is available online for purchase $36.95 from publisher. Sorry I can't scan and put it online as it is copyrighted.
I'm not picking a fight. Just pointing out how difficult it is to draw conclusions from statistics sometimes.

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