Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey

Abstract

Background Acute benzodiazepine withdrawal has been described, but literature regarding the benzodiazepine-induced neurological injury that may result in enduring symptoms and life consequences is scant. Objective We conducted an internet survey of current and former benzodiazepine users and asked about their symptoms and adverse life events attributed to benzodiazepine use. Methods This is a secondary analysis of the largest survey ever conducted with 1,207 benzodiazepine users from benzodiazepine support groups and health/wellness sites who completed the survey. Respondents included those still taking benzodiazepines (n = 136), tapering (n = 294), or fully discontinued (n = 763). Results The survey asked about 23 specific symptoms and more than half of the respondents who experienced low energy, distractedness, memory loss, nervousness, anxiety, and other symptoms stated that these symptoms lasted a year or longer. These symptoms were often reported as de novo and distinct from the symptoms for which the benzodiazepines were originally prescribed. A subset of respondents stated that symptoms persisted even after benzodiazepines had been discontinued for a year or more. Adverse life consequences were reported by many respondents as well. Limitations This was a self-selected internet survey with no control group. No independent psychiatric diagnoses could be made in participants. Conclusions Many prolonged symptoms subsequent to benzodiazepine use and discontinuation (benzodiazepine-induced neurological dysfunction) have been shown in a large survey of benzodiazepine users. Benzodiazepine-induced neurological dysfunction (BIND) has been proposed as a term to describe symptoms and associated adverse life consequences that may emerge during benzodiazepine use, tapering, and continue after benzodiazepine discontinuation. Not all people who take benzodiazepines will develop BIND and risk factors for BIND remain to be elucidated. Further pathogenic and clinical study of BIND is needed.

‘We need more support and doctors that understand the process of tapering …’: A content analysis of free‐text responses to a questionnaire on discontinuing long‐term benzodiazepine receptor agonist use

“…A recent online survey highlighted that many individuals report experiencing multiple distressing symptoms because of BZRA use lasting from months to years after discontinuation 30 . In light of the potential for protracted withdrawal symptoms resulting from BZRA use, a team of experts representing academic, clinical and lived experience of BZRA discontinuation has proposed the term ‘Benzodiazepine‐Induced Neurological Dysfunction’, which is defined as ‘a constellation of functionally limiting neurologic symptoms (both physical and psychological) that are the consequence of neuroadaptation and/or neurotoxicity to benzodiazepine exposure’ 31 . It is postulated that these symptoms may begin while taking or tapering BZRAs, and can persist following discontinuation for weeks, months or even years.…”

O uso irracional e prolongado de benzodiazepínicos como potenciais causadores de demência em idosos

“…Além disso, sedação excessiva, aumento de quedas em pacientes idosos e desenvolvimento de demência são efeitos preocupantes, independentemente do tempo de uso dos benzodiazepínicos. O uso prolongado de benzodiazepínicos contribui para o desenvolvimento de demência em idosos (RITVO et al, 2023).…”

“…Embora os efeitos dos benzodiazepínicos na fisiopatologia e nos estágios progressivos da demência permaneçam incertos, provavelmente não há argumento de que o uso racional de BZDs aumente o risco de demência, a menos que exceda três meses (Ritvo et al, 2023).…”

Prescribing and deprescribing guidance for benzodiazepine and benzodiazepine receptor agonist use in adults with depression, anxiety, and insomnia: an international scoping review

“…The public health implications for BZD & BZRA use are continuously being revised in light-of newer pharmacoepidemiologic studies and patient engagement research both of which elucidate these issues in greater detail. 15 , 16 …”