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An evaluation of persisting cognitive effects after withdrawal from long-term benzodiazepine use

Published online by Cambridge University Press:  04 May 2005

MELINDA J. BARKER ,
KENNETH M. GREENWOOD ,
MARTIN JACKSON  and
SIMON F. CROWE
MELINDA J. BARKER
Affiliation:
School of Psychological Science, La Trobe University, Victoria 3086, Australia
KENNETH M. GREENWOOD
Affiliation:
School of Psychological Science, La Trobe University, Victoria 3086, Australia
MARTIN JACKSON
Affiliation:
School of Psychological Science, La Trobe University, Victoria 3086, Australia
SIMON F. CROWE
Affiliation:
School of Psychological Science, La Trobe University, Victoria 3086, Australia
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Abstract

Twenty participants with self-reported long-term benzodiazepine use (mean 108 months) who had previously withdrawn from medication (mean 42 months) were administered a battery of neuropsychological tests. Each long-term user was case matched for age, sex, and education to two control participants who reported never taking benzodiazepines (those with and those without anxiety). The results indicated that long-term benzodiazepine use may lead to impairments in the areas of verbal memory, motor control/performance, and nonverbal memory but not visuospatial skills and attention/concentration. The length of abstinence (> 6 months) indicates that these impairments persist well beyond cessation of benzodiazepine use. However, observed impairments in the area of nonverbal memory were not solely attributable to benzodiazepine use and may be influenced by the elevated anxiety levels present in both the case and the anxious control group. (JINS, 2005, 11, 281–289.)

Keywords

BenzodiazepinesLong-term effectsNeuropsychological assessmentCognitive ability
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 3 , May 2005 , pp. 281 - 289
Copyright
© 2005 The International Neuropsychological Society

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References

REFERENCES

Aranko, K., Mattila, M.J., & Seppala, T. (1983). Development of tolerance and cross-tolerance to the psychomotor actions of lorazepam and diazepam in man. British Journal of Pharmacology, 15, 545–552.Google Scholar
Ashton, H. (1986). Adverse effects of prolonged benzodiazepine use. Adverse Drug Reaction Bulletin, 118, 440–443.Google Scholar
Ashton, H. (1995). Toxicity and adverse consequences of benzodiazepine use. Psychiatric Annals, 25, 158–165.Google Scholar
Australian Institute of Health and Welfare. (2000). Australia's Health: The Seventh Biennial Health Report of the Australian Institute of Health and Welfare. Canberra: Australian Institute of Health and Welfare. Cat. 19.
Balter, M.B., Manheimer, D.I., Mellinger, G.D., & Uhlenhuth, E.H. (1984). A cross-national comparison of anti-anxiety/sedative drug use. Current Medical Research Opinion, 8 (Suppl. 4), 5–20.Google Scholar
Barker, M.J., Greenwood, K.M., Jackson, M., & Crowe, S.F. (2004a). The cognitive effects of long-term benzodiazepine use: A meta-analysis. CNS Drugs, 18, 37–48.Google Scholar
Barker, M.J., Greenwood, K.M., Jackson, M., & Crowe, S.F. (2004b). Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: A meta-analysis. Archives of Clinical Neuropsychology, 19, 437–454.Google Scholar
Barker, M.J., Jackson, M., Greenwood, K.M., & Crowe, S.F. (2003). Cognitive effects of Benzodiazepine use: A review. Australian Psychologist, 38, 202–231.Google Scholar
Benton, A.L., deS Hamsher, K., Varney, N.R., & Spreen, O. (1983). Contributions to neuropsychological assessment. New York: Oxford University Press.
Bergman, H., Borg, S., Engelbrektson, K., & Vikander, B. (1989). Dependence on sedative-hypnotics: Neuropsychological impairment, field dependence and clinical course in a 5-year follow-up study. British Journal of Addiction, 84, 547–553.Google Scholar
Bergman, H., Borg, S., & Holm, S. (1980). Neuropsychological impairment and exclusive abuse of sedatives or hypnotics. American Journal of Psychiatry, 137, 215–217.Google Scholar
Birzele, H.J. (1992). Benzodiazepine induced amnesia after long-term medication and during withdrawal. European Review of Applied Psychology, 42, 277–282.Google Scholar
Brosan, L., Broadbent, D., Nutt, D., & Broadbent, M. (1986). Performance effects of diazepam during and after prolonged administration. Psychological Medicine, 16, 561–571.Google Scholar
Chen, Y. (1990). Long-term benzodiazepine treatment: Is it ever justified? Human Psychopharmacology Clinical and Experimental, 5, 301–312.Google Scholar
Cohen, J. (1988). Statistical power analyses for the behavioral sciences (2nd ed.). Hillsdale, New Jersey: Lawrence Erlbaum Associates.
Curran, H.V. (1986). Tranquillising memories: A review of the effects of benzodiazepines on human memory. Biological Psychology, 23, 179–213.Google Scholar
Curran, H.V. (1992). Memory functions, alertness and mood of long-term benzodiazepine users: A preliminary investigation of the effects of a normal daily dose. Journal of Psychopharmacology, 6, 69–75.Google Scholar
Curran, H.V., Bond, A., O'Sullivan, G., Bruce, M., Marks, I., Lelliot, P., Shine, P., & Lader, M. (1994). Memory functions, alprazolam and exposure therapy: A controlled longitudinal study of agoraphobia with panic disorder. Psychological Medicine, 24, 969–976.Google Scholar
Golombok, S. (1989). Causes, effects and treatment of long-term benzodiazepine use: A review of psychological perspectives. Human Psychopharmacology Clinical and Experimental, 4, 15–20.Google Scholar
Golombok, S., Moodley, P., & Lader, M. (1988). Cognitive impairment in long-term benzodiazepine users. Psychological-Medicine, 18, 365–374.Google Scholar
Gorenstein, C., Bernik, M.A., & Pompeia, S. (1994). Differential acute psychomotor and cognitive effects of diazepam on long-term benzodiazepine users. International Clinical Psychopharmacology, 9, 145–153.Google Scholar
Gorenstein, C., Bernik, M.A., Pompeia, S., & Marcourakis, T. (1995). Impairment of performance associated with long-term use of benzodiazepines. Journal of Psychopharmacology, 9, 313–318.Google Scholar
Kaufman, A.S. & Kaufman, N.L. (1983). K-ABC Kaufman Assessment Battery for Children. Circle Pines, Minnesota: American Guidance Service.
Kirk, R.E. (1995). Experimental design: Procedures for the behavioural sciences (3rd ed.). Pacific Grove, California: Brooks/Cole Publishing Company.
Lezak, M.D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.
Lucki, I., Rickels, K., & Geller, A.M. (1986). Chronic use of benzodiazepines and psychomotor and cognitive test performance. Psychopharmacology, 88, 426–433.Google Scholar
Malec, J.F., Ivnik, R.J., Smith, G.E., Tangalos, E.G., Petersen, R.C., Kokmen, E., & Kurland, L.T. (1992). Visual Spatial Learning Test: normative data and further validation. Psychological Assessment, 4, 433–441.Google Scholar
Massin-Krauss, M., Bacon, E., & Danion, J.M. (2002). Effects of the benzodiazepine lorazepam on monitoring and control processes in semantic memory. Consciousness and Cognition, 11, 123–127.Google Scholar
McMillan, J. & Jones, F.L. (2000). The ANU3_2 scale: A revised occupational status for Australia. Journal of Sociology, 36, 64–80.Google Scholar
Mellinger, G.D., Balter, B.B., & Uhlenhuth, E.H. (1984). Prevalence and correlates of the long-term regular use of anxiolytics. Journal of the American Medical Association, 251, 375–379.Google Scholar
Mintzer, M.Z., Griffiths, R.R., Contoreggi, C., Kimes, A.S., London, E.D., & Ernst, M. (2001). Effects of Triazolam on brain activity during episodic memory encoding. Neuropsychopharmacology, 25, 744–756.Google Scholar
Nelson, H.E. & Willison, J. (1991). National Adult Reading Test (NART): Test Manual. (2nd ed.). Windsor, UK: NFER Nelson.
Petursson, H., Gudjonsson, G.H., & Lader, M.H. (1983). Psychometric performance during withdrawal from long-term benzodiazepine treatment. Psychopharmacology, 81, 345–349.Google Scholar
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, Arizona: Neuropsychology Press.
Rosenthal, R. (1991). Meta-analytic procedures of social research (revised ed.). London, UK: Sage Publications.
Sakol, M.S. & Power, K.G. (1988). The effects of long-term benzodiazepine treatment and graded withdrawal on psychometric performance. Psychopharmacology, 95, 135–138.Google Scholar
Salzman, C., Fisher, J., Nobel, K., & Glassman, R. (1992). Cognitive improvement following benzodiazepine discontinuation in elderly nursing home residents. International Journal of Geriatric Psychiatry, 7, 89–93.Google Scholar
Spielberger, C.D. (1983). State-Trait Anxiety Inventory. Palo Alto, California: Mind Garden.
Spreen, O. & Strauss, E. (1998). A compendium of neuropsychological tests: Administration, norms, and commentary (2nd ed.). New York: Oxford University Press.
Tata, P.R., Rollings, J., Collins, M., Pickering, A., & Jacobson, R.R. (1994). Lack of cognitive recovery following withdrawal from long-term benzodiazepine use. Psychological Medicine, 24, 203–213.Google Scholar
Tiffin, J. (1987). Purdue Pegboard Examiner's Manual (3rd ed.). Illinois: National Computer Systems.
Toenne, U., Hiltunen, A.J., Vikander, B., Engelbrektsson, K., Bergman, H., Bergman, I., Leifman, H., & Borg, S. (1995). Neuropsychological changes during steady-state drug use, withdrawal and abstinence in primary benzodiazepine-dependent patients. Acta Psychiatrica Scandinavica, 91, 299–304.Google Scholar
Walsh, K. (1985). Understanding brain damage: A primer of neuropsychological evaluation. London, UK: Churchill Livingstone.
Wechsler, D. (1997). Wechsler Memory Scale–Third Edition (WMS–III). San Antonio, Texas: The Psychological Corporation.
Wechsler, D. (1999). Wechsler Abbreviated Test of Intelligence (WASI). San Antonio, Texas: The Psychological Corporation.
Wolkowitz, O.M., Weingarter, H., Thompson, K., Pickar, D., Paul, S.M., & Hommer, D.W. (1987). Diazepam-induced amnesia: A neuropharmacological model of an ‘organic-amnesic syndrome’. American Journal of Psychiatry, 144, 25–29.Google Scholar
Zandstra, S.M., Furer, J.W., van de Lisdonk, E.H., van't Hof, M., Bor, J.H.J., van Weel, C., & Zitman, F.G. (2002). Different study criteria affect the prevalence of benzodiazepine use. Social Psychiatry and Psychiatric Epidemiology, 37, 139–144.Google Scholar