Popular Anxiety Medications That Could Increase Your Risk Of Dementia

If you've been diagnosed with anxiety, you're definitely not alone. According to the National Institute of Mental Health, nearly one in three people will experience an anxiety disorder at some point in their lives. Anxiety is typically treated with therapy, medication, or a combination of both. The first-line anxiety medications are usually selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) because they tend to cause fewer side effects than older medications like benzodiazepines.

(Read about the harmful effects of taking the benzodiazepine Ativan.)

While benzodiazepines can ease anxiety within hours, they aren't recommended for long-term use because they can be habit-forming. If you need an example from modern media, think of Victoria Ratliff's attachment to lorazepam in "The White Lotus." Beyond that, using benzodiazepines over an extended period may raise your risk of dementia. A 2017 meta-analysis in Neuroepidemiology that reviewed 10 studies found that benzodiazepine use was linked to a 78% higher risk of developing dementia. However, more recent research shows a weaker link.

If you or someone you know needs help with mental health, please contact the Crisis Text Line by texting HOME to 741741, call the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264), or visit the National Institute of Mental Health website.

Benzodiazepines are drugs like Xanax, Klonopin, and Ativan. They work by affecting a brain chemical called GABA (gamma-aminobutyric acid), which helps calm the brain. These drugs relax areas involved in memory, reasoning, and emotions. Using benzodiazepines for longer than three months can lead to confusion, memory problems, and slower thinking (per Edgewood Health Network).

A 2024 study in BMC Medicine looked at how benzodiazepines affect the brain using MRI scans in adults over age 45. The researchers found that people who were currently taking benzodiazepines had smaller brain volumes in three key areas: the hippocampus, amygdala, and thalamus. These brain regions play important roles in memory, emotional processing, and motor functions and are also vulnerable in dementia. Benzodiazepine users also showed faster shrinkage (atrophy) of the hippocampus after three years.

Another part of the study followed more than 5,400 people, about half of whom had used benzodiazepines at some point in the previous 15 years. After roughly 11 years, there was no overall increase in dementia risk for people who used benzodiazepines compared to those who never did. However, when researchers looked more closely, they found that people who had taken high cumulative doses of anxiolytic benzodiazepines to treat anxiety had a 33% higher risk of developing dementia. Examples of anxiolytic benzodiazepines include Klonopin (clonazepam), Valium (diazepam), Ativan (lorazepam), and Xanax (alprazolam).

One of the early signs of dementia is anxiety, which makes it hard for researchers to figure out cause and effect. In other words, older adults with undiagnosed dementia may experience anxiety and be prescribed a benzodiazepine to help manage it. If you're already taking benzodiazepines, quitting may reduce your risk of developing dementia. A 2011 study in the American Journal of Geriatric Psychiatry looked at people who stopped taking benzodiazepines and their risk of dementia. The study found that current benzodiazepine users had a 2.7 times higher risk of dementia, but those who stopped for three years or more had the same risk as people who never took them.

(Find out which heartburn medications increase your risk of dementia.)

Even though research on the link between benzodiazepines and dementia is still mixed, the American Geriatrics Society (AGS) recommends that older adults avoid using these medications. The AGS updates its list of potentially inappropriate medications for older adults every three years based on the latest medical research. In the 2023 update published in the Journal of the American Geriatrics Society, benzodiazepines appear on the list because they increase the risk of cognitive impairment, delirium, falls, fractures, and car accidents. Older adults are also more sensitive to the effects of these medications and face a higher risk of physical dependence.