Benzo use associated with increased Alzheimer's risk in older adults

[AcronymAllergy]

Saw this pop up in one of my feeds and thought it was interesting:

http://newoldage.blogs.nytimes.com/...e=blogs&_php=true&_type=blogs&ref=health&_r=2

I know we've been saying for years that chronic benzo use is bad, but that doesn't seem to have gained a whole lot of traction. Maybe this'll end up catching some folks' attention.

Link to the original article, which is full-text, is provided in story.

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[WisNeuro]

Let's not forget the already well-established finding of benzo use and an increase in delirium and falls in the elderly. I cringe when I look through my patients chart and see that they have been on Xanax as a maintenance drug for any length of time. It's almost as useless as Aricept, just more damaging in the long run.

 

[AcronymAllergy]

Let's not forget the already well-established finding of benzo use and an increase in delirium and falls in the elderly. I cringe when I look through my patients chart and see that they have been on Xanax as a maintenance drug for any length of time. It's almost as useless as Aricept, just more damaging in the long run.

Yep, they specifically mention that particular prior finding (for both benzos and Z-drugs) in the intro. Now they've got information suggesting that prolonged (i.e., <180 days I think it was) benzo use 5-10 years pre-diagnosis is associted with increased risk of AD, and that there was an associated dose-response relationship.

 

[WisNeuro]

I'm only a fan of klonopin when used in conjunction with other meds in epilepsy. It's not a good thing to prescribe for panic, as I usually see it prescribed.

 

[Therapist4Chnge]

As one of my pharma professors used to say…"a benzo is *great* at what it does"…but that doesn't mean it is great for the person. It is still one of my "desert island drugs" because it can be used effectively to treat many different things, but if given a choice…there are usually better options for most ailments.

 

[smalltownpsych]

Many medical practitioners don't seem to know this information and that is based on observations of many patients and also elderly family members from a wide variety of places and settings. It can be difficult talking to the other docs about this since they are trained to always know everything and don't seem to appreciate when a psychologist points out an error in a treatment strategy.

 

[WisNeuro]

Yeah, we had a neurologist who vehemently disagreed with us about Aricept until we showed him the preponderance of data that suggests that it's really just a more expensive stool softener.

 

[Therapist4Chnge]

There will always be providers not willing to listen, but I don't let that stop me from recommending what is supported in the research. I'm sure I've had a couple of people toss my recs, but most have actually replied and thanked me for the references/insight. I try and do it judiciously, particularly if it is the first time I have worked with them, but many are open if you can show them the data. In a few cases I've actually gotten more referrals specifically because I provide recommendations for medication and lifestyle changes…not just a cognitive eval and recs.

 

[smalltownpsych]

I have found that it goes over better if I just put info like that in my consult as as something to consider. Then it becomes their idea, too!