Benzodiazepine long-term administration is associated with impaired attention/working memory in schizophrenia: results from the national multicentre FACE-SZ data set

Abstract

BLTA is associated with impaired attention/working memory in schizophrenia. The BLTA benefit/risk ratio should be regularly reevaluated. Alternative pharmacological and non-pharmacological strategies for comorbid anxiety disorders and sleep disorders should be preferred when possible. It seems reasonable to withdraw BLTA before the start of cognitive remediation therapy, as soon as possible, to improve the effectiveness of this therapy. Limits: the delay between the last benzodiazepine intake and testing, as well as the specific class of benzodiazepines (long half-life vs. short half-life), and the number of benzodiazepine daily intakes have not been recorded in the present study. The precise motive for BLTA prescription and sleep disturbances have not been reported, which is a limit for the interpretation of the present results.

Detoxification Improves Multidomain Cognitive Dysfunction in High-Dose Benzodiazepine Abusers

“…The cognitive changes we found are in keeping with previous studies and a meta-analysis showing moderate-to-large abnormalities in all cognitive domains to long-term BZD use ( Barker et al, 2004a ; Boeuf-Cazou et al, 2011 ; Puustinen et al, 2014 ; Helmes and Østbye, 2015 ; Fond et al, 2018 ). In particular, an updated meta-analysis found statistically significant impairment of many neuropsychological domains (i.e., working memory, divided attention, processing speed, visuoconstruction, recent memory and expressive language) to long-term BZD use ( Crowe and Stranks, 2018 ).…”

“…Long-term BZD use was reported to be associated with abnormalities in cognitive functions, including attention, memory and learning ( Boeuf-Cazou et al, 2011 ; Barker et al, 2004a ; Puustinen et al, 2014 ; Helmes and Østbye, 2015 ; Fond et al, 2018 ), and higher risk of delirium, cognitive decline, falls, fractures, injuries, and road accidents ( Finkle et al, 2011 ; van der Sluiszen et al, 2017 ; Kok et al, 2018 ; Picton et al, 2018 ; Wedmann et al, 2019 ). However, most of these reports were from people at higher risk of cognitive decline, such as elderly people ( Finkle et al, 2011 ; Helmes and Østbye, 2015 ; Picton et al, 2018 ), intensive care unit patients ( Kok et al, 2018 ), or patients with schizophrenia ( Fond et al, 2018 ), whereby separating side effects of BZDs from symptoms of aging or a pathological state may be troublesome. Furthermore, BZD use was suggested to increase the risk of dementia, but studies reported contrasting data on this point, possibly because the presence of sleep disorders or neuropsychiatric symptoms in patients with preclinical dementia may lead to an increased probability of being prescribed a BZD ( Gray et al, 2016 ; Islam et al, 2016 ; Zhang et al, 2016 ).…”

Remission of depression in patients with schizophrenia and comorbid major depressive disorder: results from the FACE-SZ cohort

“…42,43 Benzodiazepine long-term administration may also have other side-effects in patients with schizophrenia, including impaired working memory and higher aggressiveness. 44,45 Although buspirone, a 5HT1A agonist, has been suggested as a potential effective antidepressant augmentation strategy, 46 only two patients in our sample received buspirone (one with current MDD and one without).…”

“…The benefit of the long-term association of antidepressants and benzodiazepine has been highly debated, with some studies suggesting an adverse long-term effect of benzodiazepine consumption by counteracting antidepressant neurogenesis 42 , 43 . Benzodiazepine long-term administration may also have other side-effects in patients with schizophrenia, including impaired working memory and higher aggressiveness 44 , 45 . Although buspirone, a 5HT1A agonist, has been suggested as a potential effective antidepressant augmentation strategy, 46 only two patients in our sample received buspirone (one with current MDD and one without).…”

C-Reactive Protein as a Peripheral Biomarker in Schizophrenia. An Updated Systematic Review

“…While many studies [for meta-analysis see ( 80 )] have suggested that anti-inflammatory add-on therapy may be effective in SZ subjects, no study has explored to date if adding anti-inflammatory agents to conventional treatment may improve cognitive function in SZ subjects with cognitive deficits and inflammatory disturbances. Anti-inflammatory strategies, combined with cognitive remediation therapy and benzodiazepine withdrawal when needed, may be the most effective personalized-medicine approach to improve cognition in SZ subjects ( 81 ).…”