Benzodiazepines are a group of medicines commonly used to treat anxiety and sleep problems.
Drugs in this family include diazepam, better known by the brand name Valium, and they can calm the brain quickly, which is why doctors may prescribe them for short-term relief.
These medicines can be very helpful, but using them for a long time has raised concerns. Older adults are especially vulnerable because long-term use has been linked with problems involving memory and thinking, as well as physical dependence.
Scientists have not fully understood why these effects happen in the brain. A study led by researchers at Ludwig Maximilian University of Munich in Germany has now provided an important clue by showing how diazepam can change connections between brain cells.
The research was published in the journal Nature Neuroscience in 2022. The team included scientists from LMU’s Center for Neuropathology and Prion Research and the German Center for Neurodegenerative Diseases.
The brain contains billions of nerve cells that constantly send information to one another. These cells communicate through tiny meeting points called synapses, which are important for learning, memory and many other brain functions.
The researchers found that long-term diazepam treatment caused some of these connections to disappear in mice. The loss was linked to microglia, which are immune cells in the brain that normally help protect brain tissue and remove damaged or unnecessary material.
Diazepam appeared to affect these cells through a protein known as TSPO. When the drug interacted with this protein, the microglia became more active around connections between nerve cells and removed more of the material found there.
To investigate the effect, the researchers gave mice a daily dose of diazepam for several weeks. They then examined changes in the animals’ brains and tested their ability to perform tasks that required learning and memory.
The mice treated with diazepam developed changes in the small structures that help nerve cells form connections. They also performed worse on tests of thinking and memory, supporting the idea that the loss of brain connections was affecting brain function.
Importantly, the researchers found that these changes were not necessarily permanent. After diazepam treatment was stopped, the effects remained for a while, but the brain connections and mental performance eventually showed signs of recovery.
This finding may help explain why doctors are often cautious about long-term benzodiazepine use, particularly in older adults. Age itself can make the brain more vulnerable to memory problems, so medicines that interfere with connections between nerve cells may create additional concerns.
However, the study was conducted mainly in mice, not in people. The results therefore do not prove that benzodiazepines cause the same brain changes in humans, and more research is needed to understand how strongly the findings apply to patients.
Benzodiazepines also remain useful medicines when they are prescribed appropriately. People who have been taking them regularly should not suddenly stop on their own because abrupt withdrawal can cause serious symptoms, and any reduction usually needs to be discussed with a doctor.
The discovery gives researchers a clearer picture of one possible way long-term diazepam use may affect memory.
It could also help scientists develop safer treatments for anxiety and sleep problems that provide the benefits of these medicines without interfering with important brain connections.
If you care about brain health, please read studies about Vitamin B9 deficiency linked to higher dementia risk, and flavonoid-rich foods could help prevent dementia.
For more health information, please see recent studies that cranberries could help boost memory, and how alcohol, coffee and tea intake influence cognitive decline.
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