Benzodiazepines are effective and widely used drugs for treating states of anxiety and sleep disorders.
A recent study from the Ludwig Maximilian University of Munich found while short-term treatments are considered safe, their long-term intake can lead to physical dependence and, particularly in the case of older people, to cognitive impairments.
The mechanisms by which benzodiazepines trigger these changes had previously been unknown.
In the study, the team was able to demonstrate that the active ingredient in the drug leads to the loss of neural connections in the brain.
A key role is played by immune cells of the brain known as microglia. Benzodiazepines bind to a specific protein, the translocator protein (TSPO), on the surface of cell organelles of the microglia.
This binding activates the microglia, which then degrade and recycle synapses—that is, the connections between nerve cells.
The scientists showed that the synapse loss in mice that had received a daily sleep-inducing dose of the benzodiazepine diazepam for several weeks led to cognitive impairments.
It was known that microglia play an important role in eliminating synapses both during brain development and in neurodegenerative diseases.
This study showed that such well-researched drugs as benzodiazepines influence this process.
When diazepam treatment was discontinued, the effect persisted for some time, but was ultimately reversible.
In the opinion of the researchers, the study could have effects on how sleep disorders and anxiety are treated in people at risk of dementia.
The study was published in Nature Neuroscience and conducted by Jochen Herms et al.
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