Study Finds 'Benzo' Sedatives Like Valium, Xanax Don't Increase Dementia Risk

A recent study has found that benzodiazepines do not increase the risk of dementia, although they may have subtle long-term effects on brain structure. This conclusion comes from research conducted on over 5,400 adults in the Netherlands, with the findings published in the journal BMC Medicine on July 2, 2024.

The study's results contradict two prior meta-analyses that suggested an increased risk of dementia associated with benzodiazepine use. However, MRI scans of more than 4,800 participants showed an association between benzodiazepine use and accelerated shrinkage in certain brain regions.

The research, led by Dr. Frank Wolters, a senior scientist in epidemiology and radiology and nuclear medicine at Erasmus Medical Center in the Netherlands, supports current guidelines that advise against long-term benzodiazepine prescriptions. The team emphasized the need for further research to explore the potential effects of benzodiazepines on brain health.

Benzodiazepines work by promoting the release of a neurotransmitter that reduces nervous system activity. They are commonly prescribed as sedatives or for treating anxiety, insomnia, and seizures, according to the Cleveland Clinic.

The study involved analyzing medical records from 2005 to 2020 and pharmacy records from 1991 to 2008. Researchers found no link between benzodiazepine use and an increased risk of dementia, regardless of the quantity consumed over time. There was also no association found between dementia risk and specific types of benzodiazepines or the duration it took for the drug's effects to wear off.

Despite the lack of a connection to dementia risk, benzodiazepine use was linked to faster reduction in the volume of the hippocampus and amygdala, areas of the brain crucial for memory and mood regulation. Additionally, certain types of benzodiazepines were linked to changes in the size of white matter, which is essential for transmitting nerve signals between different brain regions.

The study highlighted that anxiolytic benzodiazepines, which are prescribed for anxiety, caused less shrinkage of white matter. These include medications like alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Tranxene), and lorazepam (Ativan, Loreev). On the other hand, sedative-hypnotic benzodiazepines used for sleep problems contributed to a quicker reduction in white matter volume. Examples of these medications are temazepam (Restoril), triazolam (Halcion), and quazepam (Doral).

The research underscores the importance of cautious prescription practices for benzodiazepines, especially considering their potential impact on brain structure. Further investigations are needed to fully understand the long-term effects of these drugs on brain health.