Intended for healthcare professionals

Rapid response to:


Benzodiazepines and risk of Alzheimer’s disease

BMJ 2014; 349 doi: (Published 09 September 2014) Cite this as: BMJ 2014;349:g5312

Rapid Response:

Yaffe, Boustani and Fairbanks (1) commented on a carefully conducted study that showed that exposure to benzodiazepines doubled the risk of developing Alzheimer’s disease. They found it likely that use of benzodiazepines lead to permanent brain damage, which they called neurodegenerative disease. My preference is to call a spade for a spade, which is more easily understood by the patients. It is less clear that we talk about a drug induced harm if we call it a “disease”.

Yaffe, Boustani and Fairbanks also say - without any references - that depression and anxiety are considered risk factors for Alzheimer’s disease. However, the studies psychiatrists usually refer to when they make such claims do not hold water. A prominent Danish depression researcher recently mentioned in an article, that antidepressant treatment might possibly reduce the doubled risk of dementia in people who have previously had depression (2). He referred to a meta-analysis (3), which is quite typical for the research in this area. It didn’t say anything about earlier treatment and there wasn’t the least consideration that the increased risk could be caused by the antidepressant drugs the patients had received.

We know that antipsychotics shrink the brain in a dose-dependent manner (4) and benzodiazepines, antidepressants and ADHD drugs also seem to cause permanent brain damage (5). Leading psychiatrists and the drug industry usually say that it is the disease that destroys people’s brain, but it is very likely the drugs that do it, which also animal studies have found. This is an important reason why I advocate that we should use psychiatric drugs very little, and mostly in the acute phase, if people are seriously disturbed.

1. Yaffe K, Boustani M, Fairbanks RM. Benzodiazepines and risk of Alzheimer’s disease. BMJ 2014;349:g5312.

2. Videbech P. Debatten om antidepressiv medicin - Virker det, og bliver man afhængig? BestPractice Psykiatri/Neurologi 2014;maj:nr 25.

3. Ownby RL, Crocco E, Acevedo A, John V, Loewenstein D. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry 2006;63:530-8.

4. Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry 2011;68:128-37.

5. Whitaker R. Anatomy of an Epidemic. New York: Broadway Paperbacks; 2010.

Competing interests: No competing interests

06 October 2014
Peter C Gøtzsche
Professor, Director
Nordic Cochrane Centre
Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark