Xanax and permanent cognitive defects

[IcePrincess88]

I had an appointment with my pdoc today. In the past she has given me speeches about how she really doesn't like Xanax, and how she prefers to prescribe Klonopin. Well, she left the subject alone because I wasn't budging, but she brought Xanax up again today. This time she told me that Xanax could cause PERMANENT cognitive defects like memory loss and such; and that I should really consider cutting back on the Xanax. Is there any truth in this? Or is this just a scare tactic because she's not comfortable with prescribing Xanax?

[sam78]

I don't have the citations to the particular studies, perhaps someone can post them up, but yes recent research has implicated benzos as possibly raising the risk for dementia or Alzheimers in older age. I think the decision on whether to take them is a cost versus benefit issue for most people. Personally, I take klonopin and I'm willing to live with those risks considering how much it helps in being somewhat functional.

Edited June 18, 2015 by sam78

[IcePrincess88]

Oh no! I was hoping this was complete bullshit. I couldn't function without Xanax. I will say that I am on a rather high dose, but I have been for 10 years.

[sam78]

Well, I think the risk applies to the whole class of benzodiazepams, so I'm not sure how switching to klonopin might lower the risk. Most pdocs prescribe klonopin over xanax because it has a longer half-life and there also seems to be a lower propensity to abuse it. I've taken klonopin off and on for over five years.

In reality, a lot of medications have some pretty bad side effects. The atypical antipsychotics can raise your cholesterol, weight, and the risk for diabetes, among other side effects. In my opinion these side effects are more worrisome than the risk that benzo's pose. Yet, at the same time, AAP's are a real life-saver for people who do need these medications, so clearly the benefits outweigh the risks for that segment out there.

If you're really concerned then I think you should look at minimizing your dose of Xanax while still trying to retain its beneficial effects. Of course, you should only do this under your doctor's supervision since you've taken it continuously for 10 years.

[Wooster]

What I recall reading (am on my phone so awkward to look up) is that the risk for increased dementia was for elderly only, not for us young pips.

[crtclms]

Yes, what I've read is that it is a problem for age-related dementia.

[melissaw72]

^^I've heard this also.  And I have heard it in regards to all benzos, not just xanax.

[aquarian]

Coming out of lurkdom to post an article where I read about this: http://www.health.harvard.edu/blog/benzodiazepine-use-may-raise-risk-alzheimers-disease-201409107397.

Article has a link to the study published in the BMJ. The study dealt with people over age 66. Those on longer acting benzos were more at-risk than those on shorter acting benzos like xanax. Also, the study did not prove causation (i.e. that benzo use caused Alzheimer's) and states this clearly in the "Strengths and limitations" section. It could be that those in the early stages of Alzheimer's or dementia often have anxiety and sleep disorders that are treated with benzos.

There may be other studies, but I had this one bookmarked because I've taken xanax and valium over the years.

[IcePrincess88]

Thank you for the link aquarian. I just read the article, and if my understanding is right, it's "seniors"(shall we call them) that the risk is high for Alzheimer's and dementia. So, does that mean that I'm not at risk yet? And if I'm not, then why would my pdoc tell me this? I'm about to do my own research right now about it, but I also wanted to ask you guys.

[Wooster]

A lot of pdocs are very concerned about benzo abuse, largely because state medical boards and the FDA keep telling them benzos have high abuse potential. They may also be worried about being sued 30 years from now if one does go on to develop dementia Alzheimer's. 

A lot of pdocs are very conservative in their approach to benzos for those two reasons.

But mostly because of the abuse potential. 

"This is why we can't have nice things." essentially.

[Breenn]

What I recall reading (am on my phone so awkward to look up) is that the risk for increased dementia was for elderly only, not for us young pips.

Are you sure everyone here is young ?

I'm not elderly, but you can't call me young anymore either.

[IcePrincess88]

A lot of pdocs are very concerned about benzo abuse, largely because state medical boards and the FDA keep telling them benzos have high abuse potential. They may also be worried about being sued 30 years from now if one does go on to develop dementia Alzheimer's. 

A lot of pdocs are very conservative in their approach to benzos for those two reasons.

But mostly because of the abuse potential. 

"This is why we can't have nice things." essentially.

I literally just burst out laughing.  Oh lord, that was a good one. But like I've said in other posts, if I was going to abuse Xanax, I would had already done it sometime in the past 10 years that I've been on it. It's not like I'm just going to say "You know what, I think I'm going to abuse my Xanax today".

[Breenn]

Benzodiazepines in general can cause all sorts of cognitive issues, both short term and long term.

If you are very young I'd guess that the chances of long term cognitive issues is smaller.

Anyway, it's not natural stuff that you put in your body. I never had cognitive issues (for as far as I know!) till I started tapering.

Just like higher doses are not necessarily better, the same goes for lower doses. Ideally you'd not take it long term. Generalizing, I really don't think that Klonopin is safer than Xanax. Perhaps it has lower abuse potential, but there can be horrible side effects, especially if you try to come off after long term use. Keep in mind, Klonopin was first marketed as an epilepsy drug for medium/long term maintenance.

As a side note, I really don't like that doc's attitude for putting people on Klonopin so readily.

[Wooster]

As always, your mileage may vary.

Breenn, I know there are a lot of users who are older than me. I'm not exactly a spring chicken any more at this point, but I'm also nowhere near "elderly".

Some people do just fine on long term use of benzos and have no issue tapering.

Your experience, as we have already discussed elsewhere, does not appear to be common among users here.

There are absolutely valid uses for benzos. Some pdocs are more comfortable and familiar with prescribing benzos. That does not mean the "put people on Klonopin so readily." It's a judicious process that considers the individual and their circumstances, and in my case, the cost of not sleeping well for months at a time vs the risk of benzo use to help me get some quality sleep under my belt so I can start functioning again.

[San]

Many meds can agitate dementia in seniors, or those with early onset symptoms. I do not believe that benzos cause it (or other meds, like AD's or AP's that have the similar warning) but they make the effects worse if not monitored closely. 

The first pmed my pdoc used was clonazepam (klonopin) when I was 17. I've been on benzo's for 13 years now, from ativan, to valium, to xanxa, clonazepam, etc, and have never had issues with them. No cognitive issues. The first little while of starting them (and they threw in Depakote a couple weeks after putting me on clonazepam) I was bogged down and tired. After that, I was fine. I mostly had rebound anxiety when I tapered down.

I've tapered down off of some benzo's, lowered the dose with pdoc's recommendation, switched benzos, and never had an issue. The first time I took Xanax after being switched from Valium, it made me pretty sleepy, but that happened only once, and I was on a huge cocktail. I've been on huge cocktails since I was 17, generally a mood stabilizer, antipsychotic, benzo, AD, something for sleep (PRN)

I know of people with seizure disorders whose MRI's look better after years of high doses of benzos, as they're often used in seizure disorders. Something to think about. 

Benzos here, you generally have to sign them and show a health card (required whenever you see a doc, anywhere, its basically our insurance card, called "OHIP") or other government photo ID. 

[IcePrincess88]

I'm only 26, not sure where this sits on the average user's age levels. But I've been on Xanax since I was 16, so that's 10 years now. My dad was in the Marine Corps, so I was seen at a military hospital, and they are the ones who initially prescribed me Xanax for my panic attacks. As he was prescribing it(10 years ago), he was also going on about how addictive it can be. He prescribed 0.5mgs. can't remember how many. Since I was still a minor, my mother was with me at this appointment. The doctor had made the Xanax seem so dangerous that my mom wanted to keep it in her purse and if I needed one, I'd have to come ask her for one. I wasn't having ANY of that, and I handled my own medication. Very shortly after I was referred off base to a psychiatrist that kept prescribing Xanax, and I swear we went through every psych med there was to find the right combo. 

Until my recent pdoc said something about Xanax and cognitive defects I really never thought anything of it. Even after 10 years of being on it. But I also know at this point I'm "dependent" on it. If I was to just stop taking it, bad bad things would happen. But I think the Topamax I'm taking is a lot worse for my memory than the Xanax.

For benzo's in this state, at Rite-Aid, they just take your licenses and scan the back of it when you pick it up. You also sign on the little machine they have, but you have to do that for every medication.

[jt07]

For benzo's in this state, at Rite-Aid, they just take your licenses and scan the back of it when you pick it up. You also sign on the little machine they have, but you have to do that for every medication.

Wow, they don't even do that here for Ritalin which is Schedule II. Benzos are either only Schedule III or IV, I forget which.

[IcePrincess88]

Schedule IV I believe. They also do that for my pain pills and patches. What do they do there?? Just let you pick it up all willy nilly?

[jt07]

I pick it up, sign a little machine to acknowledge that I picked it up and then I pay for it. That's it.

[Wooster]

We have to show ID for pseudoephedrine for cryin' out loud. In the state below me, you have to have a prescription for it because meth is why we can't have nice things.

For controlled Rx we have to show photo ID, and for all Rx we have to sign. But only for controlled do you have to pick it up in person. Which is kind of weird if you think about it... because what if it's a pain med and you have so much pain you can't move?