They are well-established medicines, but they also harbor risks if taken for a long time. Benzodiazepines are highly addictive and make it harder for cells in our brain to communicate.
Benzodiazepines are synthetic drugs that are used, for example, to treat anxiety and sleep disorders and acute states of excitement. Some of them are also used in neurology for muscle relaxation and help epileptic seizures. They were originally developed in the 1950’s as a safer alternative to Barbiturates advertised – but around 1980 some were problems obvioussuch as an increased risk of developing dependencies.
interfering with our cognitive abilities
It is now undisputed that Benzodiazepine can also impair cognitive abilities. “Acute effects on concentration, attention and the ability to react are particularly noticeable,” explains Dr. Philipp Hessmann, specialist in psychiatry and psychotherapy and senior physician at the Oberberg day clinic in Kurfürstendamm. There is also increased daytime tiredness or sleepiness. “It has also been widely discussed and scientifically examined whether long-term use of benzodiazepines also increases the risk of dementia”. In fact, most point studies to such a risk – although due to the different methods it is difficult to establish a direct connection between the benzodiazepines and the dementia determine.
How benzodiazepines work
Scientists around Prof. Jochen Herms and Dr. Mario M. Dorostkar from the Center for Neuropathology and Prion Research at the University of Munich have now tried to examine the mechanism of action of benzodiazepines more closely. To do this, they administered four to five-month-old, genetically modified mice Diazepam, a common benzodiazepine. Using a series of behavioral, histochemical and imaging tests, the researchers showed that diazepam binds to a specific protein called TSPO (translocator protein) and ultimately interferes with the transmission of signals between nerve cells.
“Such studies on the mechanisms of action in the brain help us to better understand the long-term effects of benzodiazepines,” says Philipp Hessmann. In the future, one could also decide more precisely which people with certain risk profiles should not receive benzodiazepines. The Munich study also showed that the changes lasted for a long time, but were ultimately reversible. That would advocate—and actually emphasize—a short-term prescription guidelines and recommendations for actionthat benzodiazepines should only be taken for a short time.
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Inappropriate and risky prescriptions
Die reality unfortunately looks different: Older people in particular are often prescribed the medication for a longer period of time, although the cognitive ones are particularly common in them impairments are critical.
Why is it that so many people take benzodiazepines for months and years, despite the known dangers? From Hessmann’s personal experience, one reason could be that you get used to it or become dependent on it relatively quickly and the patients are sometimes prescribed the medication by different doctors who do not necessarily know about the other prescriptions. Once an addiction has developed, it is often difficult to taper off or withdraw from it on an outpatient basis.
On the one hand, there can be serious withdrawal symptoms, on the other hand, inpatient withdrawal treatment is a major hurdle for many patients. Therefore, one often succeeds permanent waiver not on benzodiazepines. Those who are able to give up benzodiazepines must also persevere: only about a third resist the temptation to start taking them again. “In view of the hurdles, the benzodiazepine intake is then often continued, which is a significant problem,” says Hessmann. In a publication with colleagues in 2018, he himself stated that the often inappropriate use of benzodiazepines is in line with the guidelines for the treatment of patients with dementia is in conflict.
The bright spot at the end
After all, there is also good news: According to one Analyse of statutory health insurance prescriptions, the rate of inappropriate or risky prescriptions fell from 34.8 percent in 2006 to 27.1 percent in 2015. So things are going in the right direction. Studies on the mechanism of action and a growing awareness of the problem among doctors can contribute to the use of benzodiazepines being even more cautious and thus safer in the future.
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