Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-05T04:23:08.002Z Has data issue: false hasContentIssue false

Cognitive impairment in long-term benzodiazepine users

Published online by Cambridge University Press:  09 July 2009

Susan Golombok*
Affiliation:
Institute of Psychiatry, London
Parimala Moodley
Affiliation:
Institute of Psychiatry, London
Malcolm Lader
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence. Dr Susan Golombok, Department of Social Science and Humanities, The City University, Northampton Square, London EC1V OHB.

Synopsis

In view of the very extensive and often prolonged use of benzodiazepines in therapeutic practice, this study was designed to investigate whether or not cognitive ability is impaired in longterm benzodiazepine users, and to determine the nature and extent of any deficit. Fifty patients currently taking benzodiazepines for at least one year, thirty-four who had stopped taking benzodiazepines, and a matched control group of subjects who had never taken benzodiazepines or who had taken benzodiazepines in the past for less than one year were administered a battery of neuropsychological tests designed to measure a wide range of cognitive functions. It was found that patients taking high doses of benzodiazepines for long periods of time perform poorly on tasks involving visual-spatial ability and sustained attention. This is consistent with deficits in posterior cortical cognitive function.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acker, W. & Acker, C. (1982 a). Bexley-Maudsley Automated Psychological Screening. NFER-Nelson: Windsor.Google Scholar
Acker, W. & Acker, C. (1982 b). Bexley-Maudsley Category Sorting Test. NFER-Nelson: Windsor.Google Scholar
Aranko, K., Mattila, M. J. & Bordignon, D. (1985). Psychomotor effects of alprazolam and diazepam during acute and subacute treatment, and during the follow-up phase. Acta Pharmacologica et Toxicologica 56, 364372.CrossRefGoogle ScholarPubMed
Ashton, H. (1984). Benzodiazepine withdrawal: an unfinished story British Medical Journal 288, 11351140.CrossRefGoogle ScholarPubMed
Baiter, M. B., Manheimer, D. I., Melinger, G. D. & Uhlenhuth, E. H. (1984). A cross-national comparison of antianxiety / sedative drug use. Current Medical Research & Opinion 8, (Suppl 4), 520.Google Scholar
Battig, W. F. & Montague, W. E. (1969). Category norms for verbal items in 56 categories. a replication and extension of the Conneticut Category Norms. Journal of Experimental Psychology 80, 146.CrossRefGoogle Scholar
Benton, A. L. (1968). Differential behavioural effects in frontal lobe disease. Neuropsychologia 6, 5360.CrossRefGoogle Scholar
Berg, E. A (1948). A simple objective technique for measuring flexibility in thinking. Journal of General Psychology 39, 1522.CrossRefGoogle ScholarPubMed
Bond, A. J & Lader, M. H (1972). Residual effects of hypnotics. Psychopharmacologia 25, 117132.CrossRefGoogle ScholarPubMed
Bond, A. J., James, D. C. & Lader, M. H. (1974). Sedative effects on physiological and psychological measures in anxious patients. Psychological Medicine 4, 374380.CrossRefGoogle ScholarPubMed
Bond, A. J., Lader, M. H. & Shrotriya, R. (1983). Comparative effects of a repeated dose regime of diazepam and buspirone on subjective ratings, psychological tests and the EEG. European Journal of Clinical Pharmacology 24, 463467.CrossRefGoogle ScholarPubMed
Braestrup, C. & Nielsen, M. (1985). Benzodiazepine receptors. Clinical Neuropharmacology 8, S2S7.CrossRefGoogle ScholarPubMed
Broadbent, D. E., Cooper, P. F., Fitzgerald, P. & Parkes, K. R (1982). The Cognitive Failures Questionnaire (CFQ) and its correlates British Journal of Clinical Psychology 21, 116.CrossRefGoogle ScholarPubMed
Brosan, L., Broadbent, D., Nutt, D. & Broadbent, M. (1986). Performance effects of diazepam during and after prolonged administration. Psychological Medicine 16, 561571.CrossRefGoogle ScholarPubMed
Curran, H. V. & Golombok, S. (1985). Bottling It Up. Faber & Faber: London.Google Scholar
Curran, H. V. (1986). Tranquillising memories: a review of the effects of benzodiazepines on human memory. Biological Psychology 23, 179213.CrossRefGoogle ScholarPubMed
Curran, H. V., Shine, P. & Lader, M. H. (1986). Effects of repeated doses of fluvoxamine, mianserin and placebo on memory and measures of sedation. Psychopharmacology 89, 360363.CrossRefGoogle ScholarPubMed
Eysenck, M. (1984). A Handbook of Cognitive Psychology. Lawrence Erlbaum: London.Google Scholar
Golombok, S. & Lader, M. H. (1984). The psychopharmacological effects of promazepam, diazepam and placebo on healthy human subjects. British Journal of Clinical Pharmacology 18, 127133.CrossRefGoogle Scholar
Grant, D A. & Berg, E. A. (1948). A behavioural analysis of degree of reinforcement and ease of shifting to new responses in a Weigltype card sorting problem. Journal of Experimental Psychology 38, 408411.CrossRefGoogle Scholar
Greenblatt, D. J. & Shader, R. I. (1978). Dependence, tolerance and addiction to benzodiazepines: clinical and pharmacokinetic considerations. Drug Metabolism Reviews 8, 1328.CrossRefGoogle ScholarPubMed
Hindmarch, I (1980) Psychomotor function and psychoactive drugs. British Journal of Clinical Pharmacology 10, 189209.CrossRefGoogle ScholarPubMed
Hindmarch, I. (1986). Psychoactive drugs and driving. Psychiatry in Practice 5, 610.Google Scholar
Higgitt, A. C., Lader, M. H. & Fonagy, P. (1985). Clinical management of benzodiazepine dependence. British Medical Journal 291, 688690CrossRefGoogle ScholarPubMed
Hockey, R. (1979). Stress and the cognitive components of skilled performance. In Human Stress and Cognition: an Information Processing Approach (ed. Hamilton, V. and Warburton, D.), pp. 147177John Wiley: Chichester.Google Scholar
Johnson, L. C. & Chernik, D. A. (1982) Sedative-hypnotics and human performance. Psychopharmacology 76, 101113.CrossRefGoogle ScholarPubMed
Kolb, B. & Whishaw, I. Q. (1980). Fundamentals of Human Neuropsychology. W. H. Freeman & Co: San Francisco.Google Scholar
Kornetsky, C., Vates, T S. & Kessler, E. K. (1959). A comparison of hypnotic and residual psychological effects of single doses of chlorpromazine and secobarbital in man. Journal of Pharmacology and Experimental Therapeutics 127, 5154.Google ScholarPubMed
Lader, M. H. (1983 a). Dependence of benzodiazepines. Journal of Clinical Psychiatry 44, 121127.Google ScholarPubMed
Lader, M. H. (1983 b) Benzodiazepines, psychological functioning and dementia. In Benzodiazepines Divided (ed Trimble, M. R.), pp. 309325. John Wiley: ChichesterGoogle Scholar
Lader, M. H, Curry, S. & Baker, W. J. (1980). Physiological and psychological effects of clorazepate in man. British Journal of Clinical Pharmacology 9, 8390.CrossRefGoogle ScholarPubMed
McNair, D. M. (1973). Antianxiety drugs and human performance. Archives of General Psychiatry 29, 611617.CrossRefGoogle ScholarPubMed
Moodley, P., Golombok, S. & Lader, M. (1985). Effects of clorazepate dipotassium and placebo on psychomotor skills. Perceptual and Motor Skills 61, 11211122.CrossRefGoogle ScholarPubMed
Murphy, S. M, Owen, R. T. & Tyrer, P. J. (1984). Withdrawal symptoms after 6 weeks' treatment with diazepam. Lancet ii, 1389.CrossRefGoogle Scholar
Nelson, H. (1982). The National Adult Reading Test. NFER-Nelson: Windsor.Google Scholar
Owen, R. T. & Tyrer, P. (1983). Benzodiazepine dependence: A review of the evidence. Drugs 25, 385398.CrossRefGoogle ScholarPubMed
Petursson, H., Gudjonsson, G. H. & Lader, M. H. (1983). Psychometric performance during withdrawal from long-term benzodiazepine treatment. Psychopharmacology 81, 345349.CrossRefGoogle ScholarPubMed
Petursson, H. & Lader, M. H. (1984). Dependence of Tranquillisers. Maudsley Monograph No. 28. Oxford University Press: Oxford.Google Scholar
Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills 8, 271276.CrossRefGoogle Scholar
Ron, M. (1983). The alcoholic brain: CT scan and psychological findings. Psychological Medicine Monograph Supplement 3. Cambridge University Press: Cambridge.Google Scholar
Schopf, J. (1983). Withdrawal phenomena after long term administration of benzodiazepines: a review of recent investigations. Pharmacopsychiatry 16, 18.CrossRefGoogle ScholarPubMed
Spielberger, C., Gorsuch, A. & Lushene, A. (1970). Test Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press: Palo Alto.Google Scholar
Wechsler, D. (1955). Wechsler Adult Intelligence Scales: A Manual. Psychological Corporation: New York.Google Scholar
Wittenborn, J. R. (1979). Effects of benzodiazepines on psychomotor performance. British Journal of Clinical Pharmacology 7, 61S67S.CrossRefGoogle ScholarPubMed