November 20, 2017
The Risks of Anti-Anxiety Pills

The Risks of Anti-Anxiety Pills

by Berkeley Wellness  

Many older people are overusing benzodiazepine drugs for sleep or anxiety, despite the increased risks from them, according to a study in JAMA Psychiatry—and the use increases sharply with age, especially among women. The study found that 9 percent of people over 65 were prescribed the drugs in 2008, the year covered by the study, and that one-third of these older users got prescriptions for more than 120 days. These drugs, which include lorazepam (Ativan), temazepam (Resto­ril), diazepam (Valium), and alprazolam (Xanax), can impair cognition and balance, increasing the risk of falls and car crashes. Long-term use can lead to dependence and withdrawal symptoms when discon­tinued. Some observational studies have also linked the drugs to increased risk of dementia and even premature death.

In general, "benzos" and most other sleeping or anti-anxiety pills should be used only occasionally and short term—at most for a week or two. In fact, the American Geriatrics Society advises doctors, "Don't use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation, or delirium."

Whatever your age, if you take such drugs often, talk to your doctor, who should, in any case, not simply renew your prescription without evaluating your situ­ation and discussing the possible risks. If you are dependent on the drug, it can be hard to kick the habit. It may help to grad­ually taper off, under guidance from your health care provider.

If insomnia is your problem, lifestyle changes (see 15+ Sleep Remedies), cognitive behavioral therapy, or consulta­tion with a sleep specialist are better options. If you are dealing with chronic anxiety or depression, antidepressants or therapy are preferable over the long term.

In any case, if you take a benzo or other sedative (including non-benzodiazepines such as zolpidem), take the smallest dose that works for you. Don't drink alcohol if you plan to take a pill, and don't drive the next morning, even if you don't feel groggy.