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Study highlights consequences of chronic benzodiazepine use

Jul. 19, 2023, 10:08 AM


by Danny Bonvissuto

The lived experience of colleagues who took benzodiazepines and experienced distressing effects inspired a recent study in PLOS ONE which found the depressant is linked to nervous system injury and negative life effects during and after use.

“Patients have been reporting long-term effects from benzodiazepines for over 60 years. I am one of those patients,” said Christy Huff, MD, a co-author and director of the Benzodiazepine Information Coalition, a nonprofit organization that raises awareness about the adverse effects of prescribed benzodiazepines.

“Even though I took my medication as prescribed, I still experience symptoms on a daily basis at four years off benzodiazepines. Our survey gives a voice to the patient experience and points to the need for further investigations.”

Generally thought of as safe and effective, benzodiazepines are often prescribed for anxiety, poor sleep, muscle aches and pains without proper caution about the hazards of use or physical dependence that can occur. Many patients often take them for months or years, though two to four weeks is the recommended course. Because benzodiazepines change the biochemistry of the brain, they require a slow tapering process to avoid elevated blood pressure, anxiety and seizures.

Peter Martin MD

“We want to alert patients and their physicians to the consequences of chronic benzodiazepines and to help people recognize that these medicines are not as harmless as initially believed,” said Peter Martin MD, professor of Psychiatry and Behavioral Sciences and senior author of the study.

A collaborative effort between Vanderbilt University Medical Center, the University of Colorado Anschultz Medical Campus and patient-led advocacy organizations, the study of data from a previously published survey of 1,207 current and former benzodiazepine users found that more than half of the respondents experienced memory loss, anxiety, insomnia, pain and low energy for more than a year — symptoms unrelated to the original condition for which they took the medication.

The majority of respondents reported negative effects in their personal life, such as job loss. More than 50% had suicidal thoughts or had attempted suicide.

Reid Finlayson, MD, MMHC

“Recent large studies in the Veterans Administration have shown that chronic benzodiazepine use interferes with successful management of post-traumatic stress disorder symptoms and is associated with depression of mood and increased suicidal thinking,” said Reid Finlayson, MD, MMHC, professor of Clinical Psychiatry and Behavioral Sciences at VUMC. “[Benzodiazepine] is an anesthetic agent generally assumed to be helpful for anxiety symptoms. There are a few studies that, unfortunately, show worse outcomes for anxiety symptoms, particularly if the benzodiazepine use exceeds several weeks.”

These issues were previously called by other names, including protracted withdrawal, that implied they were side effects. This study uses the term benzodiazepine-induced neurological dysfunction, or BIND, to clarify the brain changes that can happen after benzodiazepine exposure.

“Benzodiazepines are toxic to brain functioning, especially to the anxiety mechanisms in the brain,” Martin said. “Anxiety is an evolutionary characteristic of the nervous system, which is there for a reason. When our ancestors came across danger in the environment, their experienced anxiety was fight or flight. Therefore, if we abolish these signals pharmacologically, we tone down our capacities to cope with our environment. We believe this is the ultimate risk of taking benzodiazepines: Those who recover from chronic benzodiazepines need to relearn these responses to anxiety so they can be effective in their lives.”

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