Adult attention-deficit/hyperactivity disorder symptoms, cognitive dysfunction and quality of life in high-dose use of benzodiazepine and Z-drug

Abstract

High-dose use of benzodiazepines (BZDs) and Z-drugs was found to be associated with adult attention deficit/hyperactivity disorder (ADHD) and multidomain cognitive deficits, but the interplay between these factors and its effect on quality of life (QoL) is unclear. We explored (a) whether cognitive dysfunction differs in high-dose BZD/Z-drug users with and without adult ADHD and (b) the impact of cognitive deficits and adult ADHD on QoL in this substance-use disorder (SUD). From January 2015 to December 2019, we recruited 207 high-dose BZD/Z-drug users seeking treatment. We assessed the presence of adult ADHD with a screening tool, which was validated in SUD patients, and collected demographic, clinical and QoL data from the 76 included patients. A neuropsychological battery explored five cognitive domains. We found that: (a) screening for adult ADHD was frequently positive; (b) Short Form-36 (SF-36), a self-administered QoL questionnaire, was worse than the general population and worse in patients positive (ADHD+) vs. those negative (ADHD−) to ADHD screening tool; (c) executive function was significantly worse in ADHD+ than ADHD− patients; (d) some SF-36 dimensions were negatively influenced by executive dysfunction; (e) multivariate analysis showed an interplay between adult ADHD and cognitive dysfunction in worsening QoL. We documented a complex interplay between adult ADHD, cognitive dysfunction and QoL in high-dose BZD/Z-drug users. Assessing adult ADHD, neuropsychological measures and QoL may offer a full scenario of these patients, who are frequently impaired in everyday activities. Future research should explore whether pharmacological treatment might improve cognitive dysfunction and QoL in this SUD.

Adult-Attention Deficit Hyperactive Disorder Symptoms Seem Not to Influence the Outcome of an Enhanced Agonist Opioid Treatment: A 30-Year Follow-Up

“…BDZ-induced neurocognitive deficit seems to persist even following the suspension of BDZ [36,37]. It has been suggested that the clinical impact of the long-term use of BDZ may be even higher in ADHD subjects [38]. In addition, in the present study, HUD/A-ADHD patients treated with D&N AOT seem to have results that differ from those obtained in an Italian polycentric study [39].…”

Correlations of kratom (Mitragyna speciosa Korth.) use behavior and psychiatric conditions from a cross-sectional survey.

“…Benzodiazepines were also commonly used by respondents with psychiatric symptoms. In a small patient cohort using high-dose benzodiazepines, those with ADHD performed worse in cognitive function and had lower quality of life (Federico et al, 2021). Kratom, especially in lower doses (Warner et al, 2016), may be used as a stimulant self-treatment to mitigate ADHD symptoms and benzodiazepine adverse effects.…”

Long-term use of benzodiazepines in chronic insomnia: a European perspective

“…Due to the increased risk of falls, care is recommended when using BZDs in elderly subjects ( 27 ). As ADHD is often associated with sleep disturbance, caution should also be taken when prescribing BZDs or ZDs in people with ADHD ( 105 ). Furthermore, BZDs may lower the threshold for suicidal behavior in patients with depression ( 71 ).…”