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What are the effects of long term benzodiazepines use?

I suffer from a devastating anxiety since childhood that progressed to a point where I had a panic attack almost every day. Benzodiazepines (namely diazepam or clonazepam) help my symptoms immensely and allow me to function much better in school, relationships, and other areas of life. I have managed to taper myself to a fairly low dose, but can't see myself being able to go off of them in the future.

I have seen and talked to multiple doctors, and over the last two years I have tried other medications, but nothing except benzos have worked as well for me: Sertraline, Lithium, Olanzampine, Paroxetine, Fluvoxamine, Imipramine, Fluoxetine, Quetiapine and Bupropion absolutely didn't work. Others had some benefits that were outweighed by the side effects like (on an efficacy scale): Clomipramine > Venlafaxine > Escitalopram.

I am concerned about the effects of long term benzodiazepines use. While some papers appoint 'em as very harmful in a long term others don't. Some scientists argue that it's related to permanent cognitive loss (although my notes in college improved since I started taking benzos), dementia and so on... while others say that it is just part of marketing campaign to rocket the "z drugs" prescription.

Is there any research on long term HUMAN models? I mean... benzos are around since the 60's... if they were that harmful shouldn't we've already noticed it?

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    Welcome @Adriano! You ask a good question fundamentally. I edited your question to more closely meet site standards by removing a lot of the personal details and focusing on the fundamental question. Please revert your question if you disagree, otherwise check out how I changed it and see how the site guidelines apply. Thanks for joining! – DoctorWhom Sep 5 '17 at 16:13
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Benzodiazepines (benzos) are not indicated for long term treatment of anxiety disorders due to concerns with tolerance, dependence, and other adverse effects.

Serious adverse effects

Cognitive impairments (such as psychomotor retardation and memory impairment), and depression can occur secondarily to benzo use. There is evidence to suggest that the cognitive impairments may persist following cessation after long-term use in humans (1).

Benzos increase the risk of motor vehicle accidents, and hip fractures in the elderly (2). Seizures can occur during abrupt withdrawal (3).

Alternatives to Medication

Psychotherapy, most notably Cognitive Behavioural Therapy (CBT), is an effective modality of treatment for anxiety (4). It does not carry all the nasty side effects associated with psychotropic medications.

References

  1. Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis http://www.sciencedirect.com/science/article/pii/S0887617703000969
  2. Risks Associated with Long-Term Benzodiazepine Use http://www.aafp.org/afp/2013/0815/p224.html
  3. Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives http://www.aafp.org/afp/2000/0401/p2121.html
  4. The Efficacy and Effectiveness of Psychological Treatments http://www.cpa.ca/docs/File/Practice/TheEfficacyAndEffectivenessOfPsychologicalTreatments_web.pdf
  • Excellent response. Of note, for psychotherapy, it's primarily cognitive behavioral therapy that has the strongest evidence for efficacy. – DoctorWhom Sep 6 '17 at 9:27
  • @DoctorWhom Thanks for your feedback. I'll append that to the body – user1571 Sep 6 '17 at 9:46

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