Residual Medium & Long-term Cognitive Effects of Benzodiazepine Use

This is a recently published study from Australia.  If you click on my website  https://actionpddwordpress.org/background/  you will find the full paper, if interested.  This is the abstract. 

 

The Residual Medium and Long-term Cognitive Effects of Benzodiazepine Use: An Updated Meta-Analysis.

 

Objective

This study presents an updated meta-analysis of the effects of benzodiazepines on cognitive functioning in long-term, current users of these agents, those who have recently withdrawn and on those who have successfully abstained following withdrawal. The study represents an update of the previous meta-analyses published by our group.

 

Method

A comprehensive search of the computerized databases Medline and PsycINFO was undertaken to identify studies that assessed the cognitive effects of benzodiazepines published up to 28 November 2016 (the date of the last update). Nineteen studies (eight studies published since the previous meta-analyses and 11 studies included in the previous studies) were included.

 

Results

The results of the analysis for current users revealed statistically significant, negative effects for the cognitive domains of working memory, processing speed, divided attention, visuoconstruction, recent memory, and expressive language. For those who had withdrawn and successfully abstained following withdrawal, deficits were observed for the domains of recent memory, processing speed, visuoconstruction, divided attention, working memory, and sustained attention.

 

Conclusions

The results of the study are important in that they corroborate the mounting evidence that a range of neuropsychological functions are impaired as a result of long-term benzodiazepine use, and that these are likely to persist even following withdrawal. The findings highlight the residual neurocognitive compromise associated with long-term benzodiazepine therapy as well as the important clinical implications of these results.

 

https://academic.oup.com/acn/advance-article-abstract/doi/10.1093/arclin/acx120/4734935?

Hi thanks for posting this.  I skimmed through the full paper.  I'm glad they did not try to directly correlate these findings to the physiological pathology of diseases like Alzheimer's.   

 

 

I pulled a nice quote out of the discussion.  I also noted that they have mentioned the cholinergic system, which I also believe is implicated in the adverse neuronal effects of benzodiazaphines, in particular the muscarinic family of receptors.  They also note the diverse brain regions affected by benzodiazaphines which is important relative to its devastating affects on the neural circuitry of the brain.

 

They did not mention benzodiazaphines affects on neuroplasticity in the brain, which I believe plays a role in the longer term residual effects of chronic  benzodiazaphine use.....

 

 

 

Quote

 

It is useful to consider the nature of the proposed neurophysiological mechanism driving these neurocognitive changes. Pharmacological interference has the potential to disrupt normal neurotransmission in those brain regions responsible for both amnestic and non-amnestic cognitive functioning (Tannenbaum, Paquette, Hilmer, Holroyd-Leduc, & Carnahan, 2012). It is the case that the benzodiazepines are safe and effective in short-term administration, as their therapeutic uses predominantly result from the enhancement of the central neurotransmitter gamma-aminobutyric acid (GABA) (Ashton, 1986). Benzodiazepines “act as γ-aminobutyric acid A (GABA-A) receptor agonists, which allosterically modulate GABA-A recep- tors by increasing their affinity for GABA” (Chung et al., 2016, p. 1029). The inhibitory γ-aminobutyric acid A (GABA-A) may also be implicated in modulating cognitive performance (Tannenbaum et al., 2012). When taken chronically however, benzodiazepines are capable of producing a large number of adverse effects due to the wide distribution of GABA-A recep- tors in a number of areas of the central nervous system including the spinal cord, cerebellum, limbic areas and the cerebral cortex, areas critical for intact cognitive function (Crowe & Barker, 2007). The commonly observed adverse cognitive effects of benzodiazepines, such as anterograde and retrograde amnesia likely occur as a result of GABAergic agonism (Chung et al., 2016; Tannenbaum et al., 2012). Another critical component in a discussion of mechanisms for neurocognitive changes in benzodiazepine use is the cholinergic system, which is connected to the cortex and hippocampus and implicated in memory storage and retrieval in addition to arousal, perception, and attention (Tannenbaum et al., 2012). Research indicates that the cholinergic system in addition to the histaminergic, GABAergic, and opioid receptor pathways are most commonly implicated in cognitive abilities such as learning, memory, attention, and executive function (Tannenbaum et al., 2012).

 

End quote

Hi dm123,

You mentioned that you saw the full paper. Is that something you can share with the rest of us?

 

 

Hey Lapsy, you can find it on Fiona's website.  (Haven't read it myself).

 

This is a recently published study from Australia.  If you click on my website  https://actionpddwordpress.org/background/  you will find the full paper, if interested.  This is the abstract. 

 

The Residual Medium and Long-term Cognitive Effects of Benzodiazepine Use: An Updated Meta-Analysis.

 

 

Thanks as always for the share, Fiona, and for all the incredible campaigning you're doing.  Happy Holidays, my friend, may next year be better, MUCH better for all of us.

 

I think this is the full paper:  https://actionpddwordpressdotorg.files.wordpress.com/2017/12/long-term-cog.pdf

Thanks very much! Apparently, my brain isn't working so well, or I would have seen the original reference. 

 

 

Welcome Lapis!  Just glad to help.  Merry Christmas.  May there be much healing for us all in the new year, including your foot. 

Thank you so much, benzohno! Same to you and to all here on BB! It's time for healing.

 

I've just started reading the study, and it's excellent so far. It points to the genetic factors, as well as other factors that are involved in the individual variations of responses to benzos.

Thanks for sharing this study Fiona, I'm still wading through it bit by bit, but it looked to be a very validating study.

 

Very validating. I'm very pleased to see such a study. I'd like to see one that looks at dizziness, which happens to be my primary issue. The factors involved in balance -- vision, proprioception and the vestibular system -- are mediated through the cerebellum. Presumably, it can be affected by long-term benzodiazepine use in the same way as the other cognitive functions.

Hi everyone

 

Glad you found the paper useful, I did read it as much as I could and now I have forgotten most of it!!  >

 

My mind is stuffed full of information from campaigning and it seems it can only cope with so much. 

 

I am sorry you still have all these problems, Lapis.

 

I wish you all the best for 2018 and hope it brings some more healing and a better quality of life.

 

Best wishes

 

Fiona 

Thanks so much, Fiona. I wish you a good New Year as well. I think it's already past midnight there, so it's 2018 across the pond.

 

I've printed out that study, and it will add it to my file. It's a good one. It doesn't include any examples of people beyond the 10-month-off point, as far as I can tell, but still, it's quite validating with regards to symptoms carrying on for months after someone has come off a benzo.

 

While I'm not suffering cognitively, I'm unable to walk due to the dizziness/disequilibrium, which has caused a fracture in one foot and made my already-bad other foot even worse. Pretty brutal experience, I must say. Quite terrifying on a daily basis.

 

May 2018 bring us all better health!