Cognition and behavioural functions are some of the most complex functions performed by the human brain. Any impairment acquired during life in any of these functions results in a decline in the occupational and functional abilities of the subject. Dementia is a collection of the several symptoms of what disease processes of the brain could do to these functions. Clinically, Dementia has been defined as a degenerative condition of the central nervous system in which progressive decline in cognitive function is the key manifestation. This occurs principally due to damage or disease to the brain beyond what might be expected from normal ageing. Despite the usual portrayals in of dementia affecting only the geriatric population, this affliction can grab people of all ages, ability levels and health conditions. Memory, judgemental capacity, language, attention, problem solving, etc are the areas particularly affected.
Benzodiazepines, the class of sedative-hypnotic pills popular by the “common sleeping pills” tag, are the ones most widely prescribed by physicians for insomnia and anxiety disorders. All the readers must be very familiar with “Alprax”, the sure-shot remedy to pre-exam insomnia, by now. The composition of the above mentioned pharmaceutical product is “alprazolam”, which again belongs to the class of benzodiazepines. It will be a matter of utter dismay on the part of these anti-insomnia drug users to know that benzodiazepines have been liked with an increased risk of dementia in the elderly subjects.
A Research team from the University of Bordeaux in France found that adults aged 65 years and above who started using this type of drugs are 50 percent more likely to develop dementia within the next 15 years or so. However, this is not the only and first instance when the safety of these drugs has come into interrogation. Sleep driving and other somnambulistic behaviour with no memory of past events has occurred with benzodiazepines in sleep disorders. This prompted the Food and Drug administration to issue warnings of the potential hazards of sleeping pills in 2007.
Dose-related anterograde amnesia is another significant effect of benzodiazepines to worry about. While this property has been useful in procedures like endoscopy to make the patient cooperative during the uncomfortable clinical procedure and be amnesic regarding it afterwards, it has also been misutilized in several criminal cases. Previous studies have also linked these drugs to falls and fall-related fractures.
Elderly patients are more vulnerable to these sedative effects of benzodiazepines which is very evident by the fact that the most common reversible cause of confusional state in the elderly is the overuse of sedative-hypnotics. Lethargy, states of exhaustion or symptoms equivalent to those of ethanol intoxication are the manifestations in higher doses.
Sleeping pills are the drugs most frequently involved in deliberate overdoses because of their general availability as most commonly prescribed pharmacological agents. Alprazolam is purposely more toxic in overdose than other benzodiazepines. Many patients as well as others with minor sleep disturbances take these drugs for years despite guidelines suggesting short-term use. Weighing up the benefits of these drugs and wherever possible, limiting the prescription to a few weeks could be the measures the physicians can take to minimize the unwanted added effects of sleeping pills.