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Dr. Bob is Robert Hsiung, MD,
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Posted by iforgotmypassword on April 29, 2011, at 12:37:27
Wikipedia references studies that seem to suggest very strongly that there is risk of cognitive decline with (not even) long term use of benzodiazepines, with it being unclear whether or not decline is alleviated after discontinuation of the benzos, even after 6 months. I know this sort of thing becomes almost political, and many people on the internet are very adamant that any such ideas are wrong, often pointing out non-existant problems in the study like that they only tested abusers taking megadoses, etc. which aren't true.
I want to avoid a competitive pseudopolitical debate about whether the studies are right or wrong, and merely go with the assumption that the studies exist. I need to know if there is any reason to believe that z-drugs, well, zopiclone would not cause the same measurable lasting cognitive impact, real or presumed. I was quite dependent on lorazepam's unique effectiveness for what I experienced as an auto-activaction defecit, which I am also not going to much further into and let more people tell me "everyone suffers from these problems", they've destroyed my life, and in a strange way I can feel are related to the movement problems I have frequently, not just the locking up but the excessive movement problems as well (like chewing, grimacing, pacing).
I thought that zopiclone was somewhat more selective than benzos, leaving gamma subunits alone but with no selectivity between alpha one to alpha 5, not being as specific as zolpidem and zaleplon. Presuming I am under the right impression, that benzos are less selective, is there any reason gamma subunits, or somewhere else they show effects that z-drugs dont, might cause cognitive deterioration while effects alpha-1-5 subunits would not?
The reason I am very concerned is that cognitive symptoms already affect me greatly, I may as well be a permanently drunk person, and I always fail at trying to work. What may be insignificant for someone else may be something I cannot spare.
The section "cognitive status" has a lot of references, but I cannot find anything confirming or denying danger with z-drugs:
http://en.wikipedia.org/wiki/Long-term_effects_of_benzodiazepines
Posted by mtdewcmu on April 29, 2011, at 17:25:11
In reply to less cognitive decline w/ zopiclone vs lorazepam?, posted by iforgotmypassword on April 29, 2011, at 12:37:27
I did not read the entire wikipedia article, but my general feeling is that benzo-associated brain atrophy and cognitive decline is probably not properly considered neurotoxicity the way alcohol addiction or methamphetamine addiction causes it. I think of it as more like the way your muscles atrophy when you don't use them. Zopiclone, if used for sleep, would probably cause less decline, since the effects have a chance to wear off. I'm not aware of any well-known acute neurotoxicity syndrome from benzos, although withdrawal seizures would not be good for your brain, or even going through a too-rapid withdrawal in the absence of seizures. Benzodiazepines are more often mentioned as neuroprotective in studies of other sources of neurotoxicity.
But if you are benzoed-out for decades, it is probably no better for you than being constantly stoned on pot or addicted to heroin for a similar length of time. That is partly why they are considered 3rd-line or 4th-line treatments for chronic psych disorders. But it's still fairly early in the use of SSRIs and newer ADs. I would not be too surprised to find that long-term use causes a similar kind of progressive atrophy.
That article deals a lot with the elderly, and the elderly typically always get the worst effects from meds. It takes a very small push to put them in a state of delirium.
Posted by Phillipa on April 29, 2011, at 20:39:13
In reply to less cognitive decline w/ zopiclone vs lorazepam?, posted by iforgotmypassword on April 29, 2011, at 12:37:27
41 years of all of the above and a pregnancy with alchohol prescribed with benzos and placydyl caused no birth abnormalities in my third born. Smart as a whip. I just could go off and on them as I pleased til the internet and googling developed fear. But I'm taking lower doses today than in the beginning. I've been benzos free also without a problem. Just went back on during menopause, thyroid illness discovered, and chronic lymes disease. I feel they are safe if taken as prescribed. Always encouraged by docs to raise the dose and refuse. Phillipa
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