Well, This Is What I Think

According to a report emanating from Paris (carried by AFP) long-term use of drugs commonly prescribed for anxiety and sleeplessness is linked to a greater risk of Alzheimer’s, a study said on Wednesday. Whether chronic use of benzodiazepines actually causes the brain disease is unknown, but the link is so glaring that the question should be probed, its authors said.

Dementia affects about 36 million people worldwide, a tally that is expected to double every 20 years as life expectancy lengthens and the “baby boom” demographic bulge reaches late age.

Researchers in France and Canada, using a health insurance database in Quebec, identified 1,796 people with Alzheimer’s whose health had been monitored for at least six years before the disease was diagnosed.

They compared each individual against three times as many healthy counterparts, matched for age and gender, to see if anything unusual emerged.

They found that patients who had extensively used benzodiazepines for at least three months in the past, were up to 51 percent more likely to be diagnosed with Alzheimer’s. The risk rose the longer the patient had used the drug.

But the investigators admitted the picture was foggy.

Benzodiazepines are used to treat sleeplessness and anxiety – symptoms that are also common among people just before an Alzheimer’s diagnosis. In other words, rather than causing Alzheimer’s, the drugs were being used to ease its early symptoms, which could explain the statistical association, they said.

“Our findings are of major importance for public health,” and warranted further investigation, said the team.

“(…) A risk increase by 43-51 percent in users would generate a huge number of excess cases, even in countries where the prevalence of use of these drugs is not high.”
The paper, published by the British Medical Journal (BMJ), is led by Sophie Billioti de Gage at the University of Bordeaux, southwestern France.

In a comment, Eric Karran, head of research at Alzheimer’s Research UK, said the study gathered data over a five-year period only, whereas Alzheimer’s symptoms often appear a decade or more before diagnosis.

“It is difficult to tease out cause and effect in studies such as this,” he said. “We need more long-term research to understand this proposed link and what the underlying reasons behind it may be.”

If you are concerned

Your first step, of course, is to ask your GP or health professional. Benzodiazepines are a class of drug commonly known as tranquillisers and sleeping pills. Benzodiazepines are available on prescription only in Australia, and are mainly used for problems relating to anxiety and sleep.

Approximately 10 million scripts are written annually in Australia. Apart from a fall in prescribing in the early 1990s, prescribing rates have remained fairly constant, with a slight increase in the last few years.

It is estimated that one in 50 Australians are currently taking a benzodiazepine and have been taking the drug for longer than 6 months.

Women are prescribed benzodiazepines at twice the rate as for men, and older people (over 65) receive most of the benzodiazepine scripts for sleeping problems.

The most common benzodiazepines prescribed in Australia are Temazepam, Diazepam, Alprazolam and Oxazepam.

The following is a list of oral benzodiazepines available in Australia. Benzodiazepines are often produced by different drug companies and there may be different trade names for the same drug.

Long Acting
Generic Name	Trade Name
Diazepam	Valium
	Ducene
	Antenex
	Diazepam Elixir
	Diazepam –DP
	GENRX Diazepam
	Valpam
Clonazepam	Rivotril
Flunitrazepam	Hypnodorm
	Rohypnol
Nitrazepam	Mogadon
	Alodorm
Clobazam	Frisium
Short Acting
Generic Name	Trade Name
Alprazolam	Xanax
	Kalma
	Alprax
	Alprazolam
	Alprazolam –DP
	GENRX
	Zamhexal
Temazepam	Normison
	Temaze
	Temtabs
Oxazepam	Serepax
	Murelax
	Alepam
Lorazepam	Ativan
Bromazepam	Lexotan
Triazolam	Halcion

More information about benzodiazepines, their uses, and their brand names can be found here.

We stress we do not intend this article to cause alarm, or to encourage anyone to stop taking drugs they have been prescribed. Articles of that kind abound on the internet, and to the contrary we are of the belief that one of the reasons these drugs are prescribed so often is because they are inexpensive and effective. If you have any concerns, speak to your health professional.

However we do agree with the report’s writers that any possible causal link between them and Alzheimer’s needs to be investigated if only for it to be dismissed.

Dealing with sleeplessness

Chronic use of any drug is likely to have uncertain effects. Where benzodiazepines are prescribed for assistance with sleeplessness, we would opine that other ways to address the problem should be tried as well.

These include ensuring you have adequate physical exertion during the day (as people age they tend to become more sedentary), avoiding TV and other stimulants like smartphones and computers for at least 30 minutes before sleep, seeking to calm anxiety about whether you will go to sleep with positive awareness of your overall wellness, employing relaxation exercises, (simple deep breathing can make a huge difference), meditation, and keeping the bedroom at a mild temperature, neither too hot nor too cool. It is unwise to eat a large meal to close to bed-time. Better to eat a snack that is large enough to satisfy your hunger and then enjoy a more substantial breakfast. Reading a book is a classic and successful way to calm down before sleep, but be aware that reading a book on a Kindle or iPad can have the opposite effect – the bright light confuses your brain into thinking you want to still be awake. Similarly, lighting for reading books should be bright enough to let you see, but not too bright.

A positive decision not to worry about life issues overnight is a wise move to combat sleeplessness as well. Write down a list of everything you feel is unresolved in your life, and make a determination to tackle it the next day. Nothing can be done while you lie in bed anxiously awake anyway. This simple act of intention can result in better sleep.

It is a sad fact that sleeplessness creates a vicious circle in our lives – tiredness creates anxiety and sense of worry about our achievement and problem solving ability – the anxiety thus created keeps us awake – we get more tired and more anxious – and so it goes on … For some people it can be a devastating cycle, resulting in deep depressive episodes during which their life can be at risk, and in our observation benzodiazepines are often employed by health professionals to break the cycle. But the natural state of the human body is to sleep, and it appears that we need to find natural ways to encourage it to do so instead of simply popping a pill.