By Dr. Mercola
Up to 43 percent of older adults use benzodiazepines (Valium, Xanax, Ativan, etc.) for anxiety and insomnia, often chronically, even though their long-term effectiveness and safety remain unproven.1
International guidelines recommend short-term use of benzodiazepines, because they cause withdrawal symptoms that make discontinuation problematic. Despite this, many seniors take them for years instead of a few weeks, as is recommended.
But research has found another reason to avoid their long-term use, as new data suggests they're associated with the leading cause of dependency in older people… dementia, including Alzheimer's disease.
Use of Benzodiazepines for Three Months or More Linked to Alzheimer's
Older adults who used benzodiazepines for three months or more had a 51 percent greater risk of Alzheimer's disease than those who did not.2 The risks increased the longer the drugs were used, as well as with long-acting formulations.
It's been suggested that the drugs might be linked to dementia because anxiety or sleeping issues may be early indicators of Alzheimer's. However, this study accounted for earlier diagnosis of those conditions, and an independent link between long-term benzodiazepine use and Alzheimer's still emerged. The researchers concluded:
"Benzodiazepine use is associated with an increased risk of Alzheimer's disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern."
The findings echo at least four previous studies:
- A 2012 study found that among adults over 65, those who used benzodiazepines were 50 percent more likely to develop dementia over a 15-year period.3 This was true even when taking into account other factors that might increase dementia risk, such as age, gender, and diabetes.
- A 2009 study that found long-term use of benzodiazepines was significantly associated with an increased risk of dementia, leading researchers to recommend "long-term use of BZDs should be avoided among the elderly, who may be at a higher risk for developing dementia, in addition to other health problems."4
- A 2005 literature review, which found three of six papers reviewed found an increased risk of cognitive decline in benzodiazepine users.5
- A 2002 study that also found former use of benzodiazepines was associated with a significantly increased risk of dementia.6
Sleeping Pills Also Raise Your Risk of Premature Death and Cancer
Benzodiazepines have long been linked to an increased risk of motor vehicle accidents, which isn't surprising since common side effects include dizziness, unsteady gait and falling. They're also known to cause hip fractures, impairment of thinking and memory loss. However, one of the most disturbing "side effects" is an early death…
Research involving data from more than 10,500 people who received drugs for poor sleep (including benzodiazepines) showed that "as predicted, patients prescribed any hypnotic had substantially elevated hazards of dying compared to those prescribed no hypnotics,"7 and the association held true even when patients with poor health were taken into account -- and even if the patients took fewer than 18 pills in a year.
The study suggested that those who take such medications are not only at higher risk for certain cancers, but are nearly four times more likely to die than people who don't take them. In The Dark Side of Sleeping Pills, an e-book by one of the study's researchers, Daniel Kripke, MD, it's explained:8
"We have now published a new study of over 10,000 patients who took sleeping pills and over 20,000 matched patients who did not take sleeping pills. The patients who took sleeping pills died 4.6 times as often during follow-ups averaging 2.5 years.
Patients who took higher doses (averaging over 132 pills per year) died 5.3 times as often. Even those patients who took fewer than 18 pills per year had very significantly elevated mortality, 3.6 times that of patients who took no hypnotics.
It seems quite likely that the sleeping pills were causing early death for many of the patients. In addition, those who averaged over 132 sleeping pills per year were 35% more likely to develop a new cancer…
Theoretically, there could be confounding factors or biases in the selection of patients which caused these deaths without involving sleeping pills. We can only say that we found almost no evidence of such biases. …If sleeping pills cause even a small portion of the excess deaths and cancers associated with their use, they are too dangerous to use."
Addiction Is a Very Real Problem with Benzodiazepines
Benzodiazepines exert a calming effect by boosting the action of a neurotransmitter called gamma-aminobutyric acid (GABA) in the same way that opioids (heroin) and cannabinoids (cannabis) do. This in turn activates the gratification hormone, dopamine, in your brain.
Since the identical brain "reward pathways" are used by both types of drugs, they can be equally addictive and also may cause side effects like memory loss, hip fractures, impaired thinking, and dizziness.
Ironically, the symptoms of withdrawal from many of these anxiety medications include extreme states of anxiety – some of which are far worse than the original symptoms that justified treatment in the first place. Symptoms that may occur with benzodiazepine withdrawal include:9
|Perceptual distortions and sense of movement ||Depersonalization and derealization
||Hallucinations (visual and auditory)
|Distortion of body image
||Tingling, numbness, and altered sensation
||Formication (skin crawling)
|Sensory hypersensitivity (light, sound, taste, and smell)
||Muscle twitches and jerks
||Confusion and delirium
Further, older adults, who make up a large proportion of the dependent population, have a much more difficult time eliminating benzodiazepines and similar drugs from their bloodstreams, especially while on multiple medications, which overburden their detoxification systems. Over time, these drugs can accumulate in your body, which will increase your risk of an accidental overdose. As reported in Current Opinions in Psychiatry:10
"Despite repeated recommendations to limit benzodiazepines to short-term use (2–4 weeks), doctors worldwide are still prescribing them for months or years. This over prescribing has resulted in large populations of long-term users who have become dependent on benzodiazepines and has also led to leakage of benzodiazepines into the illicit drug market…
Recent literature shows that benzodiazepines have all the characteristics of drugs of dependence and that they are inappropriately prescribed for many patients…"
There are Many Natural Effective Treatments for Anxiety
Anxiety disorders can be debilitating and in some cases require professional guidance, counseling, and treatment (including psychotherapy and behavioral therapy). But please don't underestimate your own ability to make positive, oftentimes life-changing, decisions to help you take back control of your health. If you often feel anxious or have panic attacks, I strongly recommend:
In addition to the creation of new neurons, including those that release the calming neurotransmitter GABA, exercise boosts levels of potent brain chemicals like serotonin, dopamine, and norepinephrine, which may help buffer some of the effects of stress. Many avid exercisers also feel a sense of euphoria after a workout, sometimes known as the "runner's high." It can be quite addictive, in a good way, once you experience just how good it feels to get your heart rate up and your body moving.
The Emotional Freedom Technique (EFT)
EFT can be very effective by helping you to actually reprogram your body's reactions to the unavoidable stressors of everyday life. This includes both real and imagined stressors, which can be significant sources of anxiety. In the following video, EFT therapist Julie Schiffman discusses EFT for stress and anxiety relief. Please keep in mind that while anyone can learn to do EFT at home, self-treatment for serious issues like persistent anxiety is dangerous and NOT recommended, and you should consult with an EFT professional to get the relief you need.
Optimizing Your Gut Flora
Your gut and brain actually work in tandem, each influencing the other. This is why your intestinal health can have such a profound influence on your mental health, and vice versa; as well as the reason why your diet is so closely linked to your mental health. Prior research has shown that the probiotic Lactobacillus rhamnosus had a marked effect on GABA levels in certain brain regions and lowered the stress-induced hormone corticosterone, resulting in reduced anxiety- and depression-related behavior.11
So optimizing your gut flora with beneficial bacteria is a highly useful strategy. This is done by eliminating sugars and processed foods and eating plenty of non-starchy vegetables, avoiding processed vegetable oils, and using healthy fats. Additionally, eating plenty of fermented vegetables or taking a high-potency probiotic supplement would be useful to reestablish a healthy gut flora.
Your diet should include a high-quality source of animal-based omega-3 fats, like krill oil. The omega-3 fats EPA and DHA play an important role in your emotional well-being, and research has shown a dramatic 20 percent reduction in anxiety among med students taking omega-3s.12
If Sleep Troubles Have Got You Down…
I suggest reading my Guide to a Good Night's Sleep for 33 simple tips on improving your sleep before even considering sleeping pills. Small adjustments to your daily routine and sleeping area can go a long way to ensure uninterrupted, restful sleep (which may further help with anxiety symptoms, as well). To start, consider implementing the following changes. Number one on my list? Turn off your electronic gadgets and keep them out of your bedroom:
- Avoid watching TV or using your computer/smartphone or tablet in the evening, at least an hour or so before going to bed.
- Make sure you get BRIGHT sun exposure regularly. Your pineal gland produces melatonin roughly in approximation to the contrast of bright sun exposure in the day and complete darkness at night. If you are in darkness all day long, it can't appreciate the difference and will not optimize your melatonin production.
- Get some sun in the morning. Your circadian system needs bright light to reset itself. Ten to 15 minutes of morning sunlight will send a strong message to your internal clock that day has arrived, making it less likely to be confused by weaker light signals during the night.
- Sleep in complete darkness, or as close to it as possible. Even the tiniest glow from your clock radio could be interfering with your sleep, so cover your clock radio up at night or get rid of it altogether. Move all electrical devices at least three feet away from your bed. You may want to cover your windows with drapes or blackout shades, or wear an eye mask when you sleep.
- Install a low-wattage yellow, orange, or red light bulb if you need a source of light for navigation at night. Light in these bandwidths does not shut down melatonin production in the way that white and blue bandwidth light does. Salt lamps are handy for this purpose.
- Keep the temperature in your bedroom no higher than 70°F. Many people keep their homes too warm (particularly their upstairs bedrooms). Studies show that the optimal room temperature for sleep is between 60 to 68°F.
- Take a hot bath 90 to 120 minutes before bedtime. This increases your core body temperature, and when you get out of the bath it abruptly drops, signaling your body that you are ready to sleep.
- Avoid using loud alarm clocks. Being jolted awake each morning can be very stressful. If you are regularly getting enough sleep, you might not even need an alarm, as you'll wake up naturally.
- Be mindful of electromagnetic fields (EMFs) in your bedroom. EMFs can disrupt your pineal gland and its melatonin production, and may have other negative biological effects as well. A gauss meter is required if you want to measure EMF levels in various areas of your home. If possible, install a kill switch to turn off all electricity to your bedroom. If you need a clock, use a battery-operated one.
Both anxiety and sleep troubles are serious issues that need attention. Unfortunately, most people who suffer from these conditions either do nothing or resort to pharmaceutical drugs – many of which are ineffective and capable of destroying your health and sanity further. On the contrary, you have nothing to lose, and everything to gain, by applying the previously mentioned lifestyle modifications, and you may be surprised by how much they boost your mood and ability to sleep soundly, naturally.