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Effect of withdrawal from long-term use of temazepam,zopiclone or zolpidem as hypnotic agents on cognition in older adults |
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| Authors: | Juha Puustinen Ritva Lähteenmäki Päivi Polo-Kantola Paula Salo Tero Vahlberg Alan Lyles Pertti J Neuvonen Markku Partinen Ismo Räihä Sirkka-Liisa Kivelä |
| Institution: | 1. Department of Family Medicine, University of Turku, Lemmink?isenkatu 1, 20014, Turku, Finland 2. Medical Teaching and Research Health Centre, University Consortium of Pori, Pori, Finland 3. Department of Neurology, University of Turku, Turku, Finland 4. Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland 5. Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland 6. University of Turku, Turku, Finland 7. Sleep Research Unit, University of Turku, Turku, Finland 8. Department of Psychology, University of Turku, Turku, Finland 9. Research Unit for Psychosocial Factors, Finnish Institute of Occupational Health, Turku, Finland 10. Department of Biostatistics, University of Turku, Turku, Finland 11. College of Public Affairs, University of Baltimore, Baltimore, MD, USA 12. Division of Social Pharmacy, University of Helsinki, Helsinki, Finland 13. H?rk?tie Health Centre, Lieto, Finland 14. Clinical Pharmacology, University of Helsinki, Helsinki, Finland 15. HUSLAB, Helsinki University Central Hospital, Helsinki, Finland 16. Helsinki Sleep Clinic, Vitalmed Research Center, Helsinki, Finland 17. Haartman Institute, University of Helsinki, Helsinki, Finland 18. Turku City Hospital, Turku, Finland 19. Satakunta Central Hospital, Hospital District of Satakunta, Pori, Finland |
| Abstract: | PurposeThe aim of this study was to assess the effect of withdrawal from the long-term use of temazepam, zopiclone or zolpidem as hypnotics drugs (here referred to as BZD) on cognitive performance.MethodsNinety-two adults (age ≥55 years) with primary insomnia and who were long-term daily users of BZD volunteered to participate in a 1-month medically supported withdrawal attempt from BZD use, with a subsequent 5-month follow-up. Withdrawal was based on plasma BZD measurements at baseline, at 1 month and during subsequent regular clinical appointments. Attention and psychomotor performance were measured using the CogniSpeed® at baseline and at 1, 2 and 6 months. Reaction times were determined in the Simple Reaction Time (SRT), Two-Choice Reaction Time (2-CRT) and Vigilance tests, and errors were measured by the 2-CRT and Vigilance tests. The cognition data of the withdrawal group were also compared with a cohort of BZD non-users.ResultsEighty-nine (97 %) participants (59 women, 30 men) were followed-up for a maximum of 6 months. During the follow-up period, changes in reaction times and errors did not differ between short-term withdrawers (no residual BZD at 1 month; N?=?69), non-withdrawers (residual BZD at 1 month; N?=?20) or long-term withdrawers (N?=?34). Compared to the reaction times of the BZD-free cohort, those of BZD users were slower at baseline. The reaction times of BZD withdrawers based on the results of the SRT or 2-CRT tests during follow-up did not reach those of the BZD-free cohort, but there was no difference between these groups in the Vigilance test.ConclusionsLong-term use of BDZ as hypnotic drugs by older adults is related to prolonged impairment of attentional and psychomotor cognitive functioning that persists for at least 6 months after withdrawal. |
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