Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands.
Division Pharmacology, Utrecht University, Utrecht, The Netherlands.
Hum Psychopharmacol. 2021 Jul;36(4):e2778. doi: 10.1002/hup.2778. Epub 2021 Feb 6.
Previous research reported cognitive and psychomotor impairments in long-term users of benzodiazepine receptor agonists (BZRAs). This article explores the role of acute intoxication and clinical complaints.
Neurocognitive and on-road driving performance of 19 long-term (≥6 months) regular (≥twice weekly) BZRA users with estimated plasma concentrations, based on self-reported use, exceeding the therapeutic threshold (C +), and 31 long-term regular BZRA users below (C -), was compared to that of 76 controls.
BZRA users performed worse on tasks of response speed, processing speed, and sustained attention. Age, but not C or self-reported clinical complaints, was a significant covariate. Road-tracking performance was explained by C only. The C + group exhibited increased mean standard deviation of lateral position comparable to that at blood-alcohol concentrations of 0.5 g/L.
Functional impairments in long-term BZRA users are not attributable to self-reported clinical complaints or estimated BZRA concentrations, except for road-tracking, which was impaired in CBZRA + users. Limitations to address are the lack of assessment of objective clinical complaints, acute task related stress, and actual BZRA plasma concentrations. In conclusion, the results confirm previous findings that demonstrate inferior performance across several psychomotor and neurocognitive domains in long-term BZRA users.
先前的研究报告称，苯二氮䓬受体激动剂（BZRA）的长期使用者存在认知和精神运动损伤。本文探讨了急性中毒和临床症状的作用。
根据自我报告的使用情况，将估计的血浆浓度超过治疗阈值（C+）的 19 名长期（≥6 个月）常规（≥每周两次）BZRA 使用者和 31 名长期常规 BZRA 使用者（C-）的神经认知和道路驾驶表现与 76 名对照者进行了比较。
BZRA 使用者在反应速度、处理速度和持续注意力任务上的表现较差。年龄是显著的协变量，但 C 或自我报告的临床症状不是。仅 C 可以解释道路跟踪性能。C+组的横向位置标准差增加，与血液酒精浓度为 0.5 g/L 时的情况相当。
除了与 CBZRA+使用者相关的道路跟踪外，长期 BZRA 使用者的功能障碍与自我报告的临床症状或估计的 BZRA 浓度无关。需要解决的限制是缺乏对客观临床症状、急性任务相关压力和实际 BZRA 血浆浓度的评估。总之，这些结果证实了先前的研究发现，即长期 BZRA 使用者在多个精神运动和神经认知领域的表现均较差。
