Wednesday, September 24, 2014

Does Valium Cause Dementia?

When it comes to psychiatric medication, it’s best to be informed.

Some psychiatrists think that mental illness is all about brain chemistry and that a little of this and a little that will make all your troubles go away.

And yet, how much do we really know about the long-term effects of taking these miracle drugs? And how much do we know about taking them in combination?

Apparently, not as much as we should. Since many of them have not been around for a very long time, our knowledge is perforce limited.

Recently, newspapers have been reporting on research suggesting that benzodiapines and other anti-anxiety and sedative drugs might, when taken in excess, produce dementia and Alzheimer’s.

Benzodiapines include Valium and Klonopin, among other drugs.

One recalls that, for quite some time, psychiatrists did not know that Valium was addictive.

Those who defend the drugs suggest that it’s about correlation, not causation. People who are anxious and suffer from insomnia are more likely to get dementia, and thus, are more likely to use these medications.

The latest studies, however, suggest that it’s more about causation than correlation.

Now French and Canadian researchers are reporting — in a study designed with particular care — that benzodiazepine use is linked to higher rates of subsequent Alzheimer’s disease, and that the association strengthens with greater exposure to the drugs.

“The more the cumulative days of use, the higher the risk of later being diagnosed with dementia,” Dr. Antoine Pariente, a pharmacoepidemiologist at the University of Bordeaux and a co-author of the study, told me in an interview.

He and his colleagues reviewed medical records of almost 1,800 older people diagnosed with Alzheimer’s in the public health insurance program in Quebec, and compared them with nearly 7,200 control subjects. Most were over age 80.

About half those with Alzheimer’s and 40 percent of the control subjects had used benzodiazepines, the researchers found. That translated to a 51 percent increase in the odds of a subsequent Alzheimer’s diagnosis among the benzodiazepine users.

It was not short-term use that drove that finding: Older people who took prescribed doses for 90 days or fewer over the course of the study — patients were followed for six years or longer — had no increased risk.

But those who took the drugs longer were more likely to be diagnosed with Alzheimer’s. In older patients who took daily doses for 91 to 180 days, the risk rose 32 percent, compared to those who took none. In those who took daily doses for more than 180 days, the risk was 84 percent higher.

Let’s say that it is not yet settled science. But still, the scientists who have performed and examined these studies recommend that those who continue to take these medications be informed of the risks.

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