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长期使用苯二氮䓬类药物戒断后认知效应的持续性:一项荟萃分析。

Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis.

作者信息

Barker Melinda J, Greenwood Kenneth M, Jackson Martin, Crowe Simon F

机构信息

School of Psychological Science, La Trobe University, Victoria 3086, Australia.

出版信息

Arch Clin Neuropsychol. 2004 Apr;19(3):437-54. doi: 10.1016/S0887-6177(03)00096-9.

Abstract

Despite the widespread prescribing of benzodiazepines, uncertainty still surrounds the potential for cognitive impairment following their long-term use. Furthermore, the degree of recovery that may take place after withdrawal or the level of residual impairment, if any, that is maintained in long-term benzodiazepine users is also unclear. The current paper employed meta-analytic techniques to address two questions: (1) Does the cognitive function of long-term benzodiazepine users improve following withdrawal? (2) Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data? Results of the meta-analyses indicated that long-term benzodiazepine users do show recovery of function in many areas after withdrawal. However, there remains a significant impairment in most areas of cognition in comparison to controls or normative data. The findings of this study highlight the problems associated with long-term benzodiazepine therapy and suggest that previous benzodiazepine users would be likely to experience the benefit of improved cognitive functioning after withdrawal. However, the reviewed data did not support full restitution of function, at least in the first 6 months following cessation and suggest that there may be some permanent deficits or deficits that take longer than 6 months to completely recover.

摘要

尽管苯二氮䓬类药物的处方很普遍,但长期使用后认知功能受损的可能性仍存在不确定性。此外,停药后可能发生的恢复程度,或者长期使用苯二氮䓬类药物的使用者中是否存在残留损害以及残留损害的程度也尚不清楚。本文采用荟萃分析技术来解决两个问题:(1)长期使用苯二氮䓬类药物的使用者停药后认知功能是否改善?(2)与对照组或标准数据相比,既往长期使用苯二氮䓬类药物的使用者在随访时是否仍存在损害?荟萃分析结果表明,长期使用苯二氮䓬类药物的使用者停药后在许多方面确实显示出功能恢复。然而,与对照组或标准数据相比,大多数认知领域仍存在显著损害。本研究结果凸显了与长期苯二氮䓬类药物治疗相关的问题,并表明既往使用苯二氮䓬类药物的使用者停药后可能会从改善的认知功能中获益。然而,所审查的数据不支持功能完全恢复,至少在停药后的前6个月不支持,并表明可能存在一些永久性缺陷或需要超过6个月才能完全恢复的缺陷。

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