The influence of triazolam and flunitrazepam on isokinetic and isometric muscle performance

Zinzen, Evert; Clarijs, J. P.; Cabri, Jan; Vanderstappen, D.V.; Berg, Thomas J. van den

doi:10.1080/00140139408963624

Cited by 7 publications

(3 citation statements)

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“…Both muscle weakness and poor balance are risk factors for falls [ 11 , 27 ], and benzodiazepines are known to impair muscle strength and balance [ 16 , 28 ]. Even though the fundamental aim of the present study was to provide tools for fall and fracture prevention in a clinical context, this study was not designed to register participants’ falls.…”

Section: Discussionmentioning

confidence: 99%

“…One mechanism for the possible reduction of risk of falls and fractures after benzodiazepine withdrawal could be enhanced balance and muscle strength. Although the use of psychoactive medications has been connected to lowered muscle strength [ 15 ], clinical studies specifically concerning benzodiazepines and muscle strength are rare [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Handgrip strength and balance in older adults following withdrawal from long-term use of temazepam, zopiclone or zolpidem as hypnotics

et al. 2014

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BackgroundBenzodiazepines and related drugs affect physical functioning negatively and increase fall and fracture risk. As impaired muscle strength and balance are risk factors for falls, we examined the effects of hypnotic withdrawal on handgrip strength and balance in older adult outpatients during and after long-term use of temazepam, zopiclone and zolpidem (here collectively referred to as “benzodiazepines”).MethodsEighty-nine chronic users (59 women, 30 men) of temazepam, zopiclone or zolpidem aged ≥55 years participated in a benzodiazepine withdrawal study. Individual physician-directed withdrawal was performed gradually over a one-month period and participants were followed up to six months. Handgrip strength was assessed using a handheld dynamometer, and balance using the Short Berg’s Balance Scale during the period of benzodiazepine use (baseline), and at 1, 2, 3 weeks, and 1, 2 and 6 months after initiating withdrawal. Withdrawal outcome and persistence were determined by plasma benzodiazepine-determinations at baseline and at four weeks (“short-term withdrawers”, n = 69; “short-term non-withdrawers”, n = 20), and by interviews at six months (“long-term withdrawers”, n = 34; “long-term non-withdrawers”, n = 55). Also most of the non-withdrawers markedly reduced their benzodiazepine use.ResultsWithin three weeks after initiating withdrawal, handgrip strength improved significantly (P ≤ 0.005) compared to baseline values. Among women, long-term withdrawers improved their handgrip strength both when compared to their baseline values (P = 0.001) or to non-withdrawers (P =0.004). In men, improvement of handgrip strength from baseline was not significantly better in withdrawers than in non-withdrawers. However, men did improve their handgrip strength values compared to baseline (P = 0.002). Compared to balance test results at baseline, withdrawers improved starting from the first week after withdrawal initiation. There was, however, only a borderline difference (P = 0.054) in balance improvement between the long-term withdrawers and long-term non-withdrawers. Of note, the non-withdrawers tended to improve their handgrip strength and balance compared to baseline values, in parallel with their reduced benzodiazepine use.ConclusionsWithdrawal from long-term use of benzodiazepines can rapidly improve muscle strength and balance. Our results encourage discontinuing benzodiazepine hypnotics, particularly in older women who are at a high risk of falling and sustaining fractures.Trial registrationEU Clinical Trials Register: EudraCT2008000679530. Registered 31 October 2008

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Handgrip strength and balance in older adults following withdrawal from long-term use of temazepam, zopiclone or zolpidem as hypnotics

et al. 2014

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“…Although clinically all benzodiazepines cause a dose-related central nervous system depressant activity varying from mild impairment of task performance to hypnosis, it has been demonstrated that nightly administration of 10 mg of temazepam has little influence on the recovery of subjective, physiological and performance measures in either elite athletes or sedentary subjects after a west-bound flight across five time zones (Reilly et al 2001). Although it has been also shown that triazolam does not influence sport performance, flunitrazepam significantly lowered values for maximal isometric force and the cardiovascular parameters, thereby negatively affecting a variety of strength characteristics and several cardiovascular parameters during physical exercise (Zinzen et al 1994). Clearly, the manipulation of foods and/or beverages with ''performance-decreasing substances'' having the potential to produce sedative, hypnotic, muscle relaxant and amnesic actions cannot be considered a typical form of ergogenic aid, but nonetheless raises the possibility that this and other forms of ''doping to lose'' might be administered by athletes to either team-mates (in order to lose games) or opponents (in order to win games).…”

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confidence: 96%