Frontiers in Aging Neuroscience (Jan 2020)

Benzodiazepines and Related Drugs as a Risk Factor in Alzheimer's Disease Dementia

  • Miren Ettcheto,
  • Miren Ettcheto,
  • Miren Ettcheto,
  • Miren Ettcheto,
  • Jordi Olloquequi,
  • Elena Sánchez-López,
  • Elena Sánchez-López,
  • Elena Sánchez-López,
  • Oriol Busquets,
  • Oriol Busquets,
  • Oriol Busquets,
  • Oriol Busquets,
  • Amanda Cano,
  • Amanda Cano,
  • Amanda Cano,
  • Patricia Regina Manzine,
  • Carlos Beas-Zarate,
  • Rubén D. Castro-Torres,
  • Maria Luisa García,
  • Maria Luisa García,
  • Maria Luisa García,
  • Mónica Bulló,
  • Mónica Bulló,
  • Mónica Bulló,
  • Carme Auladell,
  • Carme Auladell,
  • Carme Auladell,
  • Jaume Folch,
  • Jaume Folch,
  • Antonio Camins,
  • Antonio Camins,
  • Antonio Camins,
  • Antonio Camins

DOI
https://doi.org/10.3389/fnagi.2019.00344
Journal volume & issue
Vol. 11

Abstract

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Benzodiazepines (BZDs) and Z-drugs are compounds widely prescribed in medical practice due to their anxiolytic, hypnotic, and muscle relaxant properties. Yet, their chronic use is associated with cases of abuse, dependence, and relapse in many patients. Furthermore, elderly people are susceptible to alterations in pharmacodynamics, pharmacokinetics as well as to drug interaction due to polypharmacy. These situations increase the risk for the appearance of cognitive affectations and the development of pathologies like Alzheimer's disease (AD). In the present work, there is a summary of some clinical studies that have evaluated the effect of BZDs and Z-drugs in the adult population with and without AD, focusing on the relationship between their use and the loss of cognitive function. Additionally, there is an assessment of preclinical studies focused on finding molecular proof on the pathways by which these drugs could be involved in AD pathogenesis. Moreover, available data (1990–2019) on BZD and Z-drug use among elderly patients, with and without AD, was compiled in this work. Finally, the relationship between the use of BZD and Z-drugs for the treatment of insomnia and the appearance of AD biomarkers was analyzed. Results pointed to a vicious circle that would worsen the condition of patients over time. Likewise, it put into relevance the need for close monitoring of those patients using BZDs that also suffer from AD. Consequently, future studies should focus on optimizing strategies for insomnia treatment in the elderly by using other substances like melatonin agonists, which is described to have a much more significant safety profile.

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