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A psychiatrist's response to the study about benzos & Alzheimer's


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The British Medical Journal (BMJ) study about the link between benzodiazepines and Alzheimer's disease drew much attention in the news when it came out last fall (2014). For those of us who have taken these medications, it likely brought up questions and fears, and perhaps a bit of hope that such attention could bring about change in prescribing practices. My personal hope is that doctors and other health professionals read the study carefully and considered its importance.

 

BMJ received a number of responses to the publication of the study. Have a look at the first response in the link below. Part of that letter represents the kind of thinking that has kept many a patient on benzodiazepines for extended periods of time. The author cites a 1991 Task Force Report --that's 25 years ago! -- as the basis for his reasoning. There are many, many pieces of literature that associate benzos with risks such as falls, fractures and motor vehicle accidents. Some of the fractures -- especially in the elderly -- can lead to death. Benzos affect balance because they are known as "vestibular suppressants" and that can be found in medical textbooks (ENT). There's been quite a bit of literature about benzodiazepines since 1991.

 

In addition to the questionable reasoning, there's a word used -- "purgorative" -- that I believe should be "pejorative". "Purgorative" is not a word. It's not a big issue, but it does erode one's confidence when reading such a response.

 

http://www.bmj.com/content/349/bmj.g5205/rapid-responses

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Hi Lapis

 

Thanks for posting.  Purgative is a word so maybe he meant that!  Not sure what the implication would be though.  Means cleansing.  ;D  Pejorative does not sound right either. 

 

I did not find the reply too worrying except that the authors did make it clear that causation was not established if I remember correctly.  The writer of the letter states otherwise. I'd have to read the article again to be sure.

 

Many people don't know the difference between causation and correlation.  It is also true that many people just see the headline message and panic so these things can cause a lot of unnecessary angst.  However, BMJ readers would  be more informed than the public.  It is a bit worrying that doctors don't read things properly.  >:(

 

This doctor is just reiterating what the authors said. A pre existing condition might predispose people to get Alzheimer's rather than the benzos.

 

Thanks for posting, as always.  :smitten:

 

 

 

 

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Hey LF, good to hear your thoughts!

 

My understanding of this doctor's letter is that he found the study results to be "pejorative" because he believes that it's fine to prescribe benzos for long periods of time. Once they've been labelled with an anxiety disorder, patients are given benzos. If he had read the study carefully, he would, indeed, have read that a firm causal relationship was NOT established by the study, but that there were enough red flag issues to warrant further study and great caution when prescribing the medications. Cognitive decline can happen over time.

 

What concerns me is the ignorance of the many problematic issues with benzos, not the least of which is balance. Vestibular suppressants (benzos, etc.) are meant for short-term use only. Even then, people are at risk of falling. He didn't mention it at all. Nor did he mention the fact that benzos can worsen issues of panic and anxiety, and require more medication to get the same effect. It's called tolerance, and it happens to many. These are well-known, well-documented problems with benzodiazepines. I can see how patients would be told they need the meds for life and they'd believe it. There'd be no attempt to try other means to reduce anxiety.

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Well, that's interesting! It's not in the dictionary, as you say, but it's used here and there. From the context of the letter, I think he meant "pejorative". I can't be sure, though. He seemed to be concerned that the study upset people. The study's authors were clear, but it's possible that the media was not. Again, there could be a number of possible errors of comprehension in this example. Ah, communication!

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Yes, it is worrying that he does not go into all the negative effects of benzos. :tickedoff:

 

Medical research findings are so often reported in the media in a less than helpful way.

 

e.g.  the risk of such and such is increased by 400% if you take drug x

 

i.e. it has gone up from 2 in 100,000 to 8 in 100,000!!

 

 

 

 

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I agree that news media needs to read and report on studies much more carefully. When this study came out, I read the whole thing, including the fine print. If someone is reporting on a study, they need to do so very carefully so that they're informing not misinforming. It may be an issue of needing to get a story out quickly. Accuracy can fall by the wayside in such cases.

 

I'm still hoping that more and more facts get out into the public eye. It's a public health issue.

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  • 3 weeks later...
I wonder what data will show for those who have been taking benzos who are not elderly. To see if there is a link to early onset dementia.
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