Authors :
Thomas Jude Rodrigues; Alshada Sharf; G. Vimal Raj; Dr. Arul Prakasam K. C.
Volume/Issue :
Volume 10 - 2025, Issue 6 - June
Google Scholar :
https://tinyurl.com/55xcdshf
DOI :
https://doi.org/10.38124/ijisrt/25jun499
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Benzodiazepines (BZDs) are used extensively for the treatment of anxiety, insomnia, seizures, and muscle spasms
because of their rapid effect. While beneficial in the short term, they are not as much researched regarding the possible
influence on thoughts and memory in the long term, especially on the elderly.This review summarizes what is known so far
about the mental side effects of long-term BZD use. Research, including some large reviews and some newer psychological
tests, suggests these drugs can lead to Problems with memory, concentration, and decision-making. Some of these issues can
even remain even after the person has stopped taking the drug. The degree of the effect seems to vary on the basis of how
long the person have been taking it, the dose, their age, other drugs they take, and even personal factors like genetics. Older
adults seem to be more susceptible. Because of these risks, experts often suggest keeping BZD use short and trying safer
alternatives like therapy or antidepressants. More long-term research is still needed, however, to learn more about the risks
and to make better treatment decisions.
References :
- Guina J, Merrill B. Benzodiazepines I: Upping the care on downers: The evidence of risks, benefits and alternatives. J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017.
- Edinoff AN, Nix CA, Hollier J, Sagrera CE, Delacroix BM, Abubakar T, Cornett EM, Kaye AM, Kaye AD. Benzodiazepines: Uses, Dangers, and Clinical Considerations. Neurol Int. 2021 Nov 10;13(4):594-607. doi: 10.3390/neurolint13040059. PMID: 34842811; PMCID: PMC8629021.
- Grover S, Avasthi A, Sinha V, Lakdawala B, Bathla M, Sethi S, Mathur DM, Kathuria P, Shah S, Baalasubramanian DS, Agarwal V, Deka K. Indian Psychiatric Society multicentric study: Prescription patterns of psychotropics in India. Indian J Psychiatry. 2014 Jul;56(3):253-64. doi: 10.4103/0019-5545.140632. PMID: 25316936; PMCID: PMC4181180.
- Barker MJ, Greenwood KM, Jackson M, Crowe SF. Cognitive effects of long-term benzodiazepine use: a meta-analysis. CNS Drugs. 2004;18(1):37-48. doi: 10.2165/00023210-200418010-00004. PMID: 14731058.
- Griffin CE 3rd, Kaye AM, Bueno FR, Kaye AD. Benzodiazepine pharmacology and central nervous system-mediated effects. Ochsner J. 2013 Summer;13(2):214-23. PMID: 23789008; PMCID: PMC3684331.
- Simon F Crowe, Elizabeth K Stranks, The Residual Medium and Long-term Cognitive Effects of Benzodiazepine Use: An Updated Meta-analysis, Archives of Clinical Neuropsychology, Volume 33, Issue 7, November 2018, Pages 901–911, https://doi.org/10.1093/arclin/acx120
- Curran HV. Tranquillising memories: a review of the effects of benzodiazepines on human memory. Biol Psychol. 1986 Oct;23(2):179-213. doi: 10.1016/0301-0511(86)90081-5. PMID: 2878691.
- *Yuan Shi, Mochen Cui, Jochen Herms, BENZODIAZEPINE DIAZEPAM INDUCES COGNITIVE IMPAIRMENT VIA TRANSLOCATOR PROTEIN (18 KDA): IMPLICATIONS ON DEMENTIA, International Journal of Neuropsychopharmacology, Volume 28, Issue Supplement_1, February 2025, Pages i295–i296, https://doi.org/10.1093/ijnp/pyae059.524
- Liu L, Jian P, Zhou Y, Zhou J, Jia L, Tang M, Zhang R, Tang Y. Is the Long-Term Use of Benzodiazepines Associated With Worse Cognition Performance in Highly Educated Older Adults? Front Psychiatry. 2020 Oct 26;11:595623. doi: 10.3389/fpsyt.2020.595623. PMID: 33192741; PMCID: PMC7649772.
- Stewart SA. The effects of benzodiazepines on cognition. J Clin Psychiatry. 2005;66 Suppl 2:9-13. PMID: 15762814.
- Picton JD, Marino AB, Nealy KL. Benzodiazepine use and cognitive decline in the elderly. Am J Health Syst Pharm. 2018 Jan 1;75(1):e6-e12. doi: 10.2146/ajhp160381. PMID: 29273607.
- Zhang Y, Zhou XH, Meranus DH, Wang L, Kukull WA. Benzodiazepine Use and Cognitive Decline in Elderly With Normal Cognition. Alzheimer Dis Assoc Disord. 2016 Apr-Jun;30(2):113-7. doi: 10.1097/WAD.0000000000000099. PMID: 26067923; PMCID: PMC4670597.
- Jenna D. Picton, Adriane Brackett Marino, Kimberly Lovin Nealy, Benzodiazepine use and cognitive decline in the elderly, American Journal of Health-System Pharmacy, Volume 75, Issue 1, 1 January 2018, Pages e6–e12, https://doi.org/10.2146/ajhp160381
- Jones JD, Mogali S, Comer SD. Polydrug abuse: a review of opioid and benzodiazepine combination use. Drug Alcohol Depend. 2012 Sep 1;125(1-2):8-18. doi: 10.1016/j.drugalcdep.2012.07.004. Epub 2012 Aug 2. PMID: 22857878; PMCID: PMC3454351.
- Votaw VR, Geyer R, Rieselbach MM, McHugh RK. The epidemiology of benzodiazepine misuse: A systematic review. Drug Alcohol Depend. 2019 Jul 1;200:95-114. doi: 10.1016/j.drugalcdep.2019.02.033. Epub 2019 May 7. PMID: 31121495; PMCID: PMC6639084.
- Konopka A, Mak M, Grzywacz A, Murawiec S, Samochowiec J. Genetic and psychosocial factors for benzodiazepine addiction. An analysis based on the results of the authors' own research conducted in a group of benzodiazepine addicted and non-addicted individuals. Postepy Hig Med Dosw (Online). 2017 Mar 13;71(0):205-213. doi: 10.5604/01.3001.0010.3805. PMID: 28345528.
- Konopka A, Pełka-Wysiecka J, Grzywacz A, Samochowiec J. Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users. Prog Neuropsychopharmacol Biol Psychiatry. 2013 Jan 10;40:229-35. doi: 10.1016/j.pnpbp.2012.09.001. Epub 2012 Sep 15. PMID: 22985941.
- Chang Y, Xie X, Liu Y, Liu M, Zhang H. Exploring clinical applications and long-term effectiveness of benzodiazepines: An integrated perspective on mechanisms, imaging, and personalized medicine. Biomed Pharmacother. 2024 Apr;173:116329. doi: 10.1016/j.biopha.2024.116329. Epub 2024 Feb 23. PMID: 38401518.
- Wu CC, Liao MH, Su CH, Poly TN, Lin MC. Benzodiazepine Use and the Risk of Dementia in the Elderly Population: An Umbrella Review of Meta-Analyses. J Pers Med. 2023 Oct 12;13(10):1485. doi: 10.3390/jpm13101485. PMID: 37888096; PMCID: PMC10608561.
- Wu CC, Liao MH, Su CH, Poly TN, Lin MC. Benzodiazepine Use and the Risk of Dementia in the Elderly Population: An Umbrella Review of Meta-Analyses. J Pers Med. 2023 Oct 12;13(10):1485. doi: 10.3390/jpm13101485. PMID: 37888096; PMCID: PMC10608561.
- Lucchetta, R.C., da Mata, B.P.M. and Mastroianni, P.d.C. (2018), Association between Development of Dementia and Use of Benzodiazepines: A Systematic Review and Meta-Analysis. Pharmacotherapy, 38: 1010-1020. https://doi.org/10.1002/phar.2170
- - Hofe Iv, Stricker BH, Vernooij MW, Ikram MA, Tiemeier H, Hillegers MHJ, et al. Benzodiazepine use in relation to long-term dementia risk and imaging markers of neurodegeneration: a population-based study. BMC Med. 2024;22:266. doi:10.1186/s12916-024-03437-5.
- Ettcheto M, Olloquequi J, Sánchez-López E, Busquets O, Cano A, Manzine PR, Beas-Zarate C, Castro-Torres RD, García ML, Bulló M, Auladell C, Folch J, Camins A. Benzodiazepines and Related Drugs as a Risk Factor in Alzheimer's Disease Dementia. Front Aging Neurosci. 2020 Jan 8;11:344. doi: 10.3389/fnagi.2019.00344. PMID: 31969812; PMCID: PMC6960222.
- Al-Kuraishy HM, Al-Gareeb AI, Alsayegh AA, Abusudah WF, Almohmadi NH, Eldahshan OA, et al. Insights on benzodiazepines' potential in Alzheimer's disease. Life Sci. 2023;320:121532. doi:10.1016/j.lfs.2023.121532.
- Billioti de Gage S, Moride Y, Ducruet T, Kurth T, Verdoux H, Tournier M, Pariente A, Bégaud B. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ. 2014 Sep 9;349:g5205. doi: 10.1136/bmj.g5205. PMID: 25208536; PMCID: PMC4159609.
- Simon F Crowe, Elizabeth K Stranks, The Residual Medium and Long-term Cognitive Effects of Benzodiazepine Use: An Updated Meta-analysis, Archives of Clinical Neuropsychology, Volume 33, Issue 7, November 2018, Pages 901–911, https://doi.org/10.1093/arclin/acx120.
- Barker MJ, Greenwood KM, Jackson M, Crowe SF. Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis. Arch Clin Neuropsychol. 2004 Apr;19(3):437-54. doi: 10.1016/S0887-6177(03)00096-9. PMID: 15033227.
- Tata PR, Rollings J, Collins M, Pickering A, Jacobson RR. Lack of cognitive recovery following withdrawal from long-term benzodiazepine use. Psychological Medicine. 1994;24(1):203-213. doi:10.1017/S0033291700026969
- Kitajima R, Miyamoto S, Tenjin T, Ojima K, Ogino S, Miyake N, Fujiwara K, Funamoto Y, Arai J, Tsukahara S, Ito Y, Tadokoro M, Anai K, Kaneda Y, Yamaguchi N. Effects of tapering of long-term benzodiazepines on cognitive function in patients with schizophrenia receiving a second-generation antipsychotic. Prog Neuropsychopharmacol Biol Psychiatry. 2012 Mar 30;36(2):300-6. doi: 10.1016/j.pnpbp.2011.11.008. Epub 2011 Nov 21. PMID: 22122880.
- Edinoff AN, Nix CA, Hollier J, Sagrera CE, Delacroix BM, Abubakar T, Cornett EM, Kaye AM, Kaye AD. Benzodiazepines: Uses, Dangers, and Clinical Considerations. Neurol Int. 2021 Nov 10;13(4):594-607. doi: 10.3390/neurolint13040059. PMID: 34842811; PMCID: PMC8629021.
- Chang Y, Xie X, Liu Y, Liu M, Zhang H. Exploring clinical applications and long-term effectiveness of benzodiazepines: An integrated perspective on mechanisms, imaging, and personalized medicine. Biomed Pharmacother. 2024 Apr;173:116329. doi: 10.1016/j.biopha.2024.116329. Epub 2024 Feb 23. PMID: 38401518.
- Guaiana G, Barbui C. Discontinuing benzodiazepines: best practices. Epidemiol Psychiatr Sci. 2016 Jun;25(3):214-6. doi: 10.1017/S2045796016000032. Epub 2016 Jan 28. PMID: 26818890; PMCID: PMC6998737.
- Paterniti S, Dufouil C, Alpérovitch A. Long-term benzodiazepine use and cognitive decline in the elderly: the Epidemiology of Vascular Aging Study. J Clin Psychopharmacol. 2002 Jun;22(3):285-93. doi: 10.1097/00004714-200206000-00009. PMID: 12006899.
- Picton JD, Marino AB, Nealy KL. Benzodiazepine use and cognitive decline in the elderly. Am J Health Syst Pharm. 2018 Jan 1;75(1):e6-e12. doi: 10.2146/ajhp160381. PMID: 29273607.
- Stewart SA. The effects of benzodiazepines on cognition. J Clin Psychiatry. 2005;66 Suppl 2:9-13. PMID: 15762814.
- Liu L, Jia L, Jian P, Zhou Y, Zhou J, Wu F, Tang Y. The Effects of Benzodiazepine Use and Abuse on Cognition in the Elders: A Systematic Review and Meta-Analysis of Comparative Studies. Front Psychiatry. 2020 Sep 17;11:00755. doi: 10.3389/fpsyt.2020.00755. PMID: 33093832; PMCID: PMC7527532.
- Massoni L. Overuse of benzodiazepines for anxiety disorders in older adults and cognitive decline: Which alternatives? Aging Health Res. 2024;4(3):100197. doi:10.1016/j.ahr.2024.100197.
Benzodiazepines (BZDs) are used extensively for the treatment of anxiety, insomnia, seizures, and muscle spasms
because of their rapid effect. While beneficial in the short term, they are not as much researched regarding the possible
influence on thoughts and memory in the long term, especially on the elderly.This review summarizes what is known so far
about the mental side effects of long-term BZD use. Research, including some large reviews and some newer psychological
tests, suggests these drugs can lead to Problems with memory, concentration, and decision-making. Some of these issues can
even remain even after the person has stopped taking the drug. The degree of the effect seems to vary on the basis of how
long the person have been taking it, the dose, their age, other drugs they take, and even personal factors like genetics. Older
adults seem to be more susceptible. Because of these risks, experts often suggest keeping BZD use short and trying safer
alternatives like therapy or antidepressants. More long-term research is still needed, however, to learn more about the risks
and to make better treatment decisions.