BZD Medications and Their Impact on Cognitive Symptoms

Benzodiazepines and Physical Symptoms

Hello Doctor: A few days ago, I inquired about whether benzodiazepines (BZD) could alleviate symptoms such as difficulty concentrating, dizziness, blurred vision, slow focus switching between near and far, distorted and shaky visual fields, visual-spatial difficulties, confusion, anterograde amnesia, and cognitive difficulties.
First, I would like to thank you for your response.
You mentioned that benzodiazepines can only treat insomnia and provide sedation, and they cannot address symptoms like dizziness and cognitive impairment.
I would like to ask you a few more questions:
1.
I have undergone numerous neurological and internal medicine examinations, and the doctors have indicated that I have anxiety disorder (multiple EEGs have shown normal wave patterns, MRI comparisons from two years ago are unchanged and normal, blood antibody tests are all negative, and endocrine levels are within normal ranges, etc.).
However, I am truly confused—can all of the aforementioned symptoms be explained by "anxiety disorder"?
2.
Following up on the above, if my symptoms can be explained by anxiety disorder, why have I experienced no reduction in symptoms while taking 2 mg of Risperidone (Risperdal) (I am not seeking a cure at this point, just symptomatic relief)?
3.
If taking Risperidone does not alleviate the above symptoms at all, does this suggest that the underlying cause of my symptoms may not be anxiety disorder, but rather the possibility of another condition (such as neurodegeneration)?
Thank you very much, Doctor.

Kid's Dad, 30~39 year old female. Ask Date: 2023/06/07

Dr. Qiu Junda reply Psychiatry

Hello.
1.
Although I cannot assess your symptoms, based on your description and the physician's diagnostic judgment, your symptoms could theoretically be explained by an anxiety disorder.
2.
If it is an anxiety disorder, the primary treatment medications are anxiolytics, and there are various anxiolytic medications to choose from.
Rifaximin is just one of them and may not necessarily be suitable for you.
If the treatment does not lead to improvement, it does not mean that it is not an anxiety issue.
You may discuss with your physician whether to change medications for better improvement.

Reply Date: 2023/06/07

More Info

Understanding the impact of benzodiazepines (BZD) on cognitive symptoms is crucial, especially for individuals experiencing a range of cognitive difficulties such as attention deficits, dizziness, and memory issues. Benzodiazepines are primarily prescribed for their anxiolytic (anti-anxiety), sedative, and muscle relaxant properties. However, their role in addressing cognitive symptoms is more complex and often limited.

1. Cognitive Symptoms and Anxiety: Your symptoms, including attention difficulties, dizziness, and memory issues, can indeed be associated with anxiety disorders. Anxiety can manifest in various ways, affecting cognitive functions such as concentration and memory. When a person is anxious, their mind may be preoccupied with worry, making it difficult to focus on tasks or remember information. This cognitive impairment can sometimes be mistaken for other neurological issues, especially when extensive medical evaluations, such as MRIs and EEGs, return normal results.
2. Benzodiazepines and Their Limitations: While benzodiazepines can provide immediate relief from anxiety symptoms, they are not typically effective for treating cognitive deficits directly. They may help reduce anxiety levels, which in turn could alleviate some cognitive symptoms indirectly. However, they do not address the underlying causes of cognitive impairment. In your case, if you have been prescribed a low dose of a benzodiazepine like lorazepam (often referred to as Ativan), it may not be sufficient to manage your symptoms effectively, especially if they are primarily cognitive in nature rather than purely anxiety-related.

3. Ineffectiveness of Medications: If you find that medications like lorazepam are not alleviating your symptoms, it does not necessarily mean that your issues are not related to anxiety. It could indicate that the specific medication is not the right fit for your particular symptoms or that your symptoms may have a multifactorial origin. Cognitive symptoms can arise from various conditions, including depression, anxiety, and even neurodegenerative disorders. Therefore, if benzodiazepines are not providing relief, it may be worthwhile to explore other treatment options, such as SSRIs (selective serotonin reuptake inhibitors) or cognitive-behavioral therapy (CBT), which can address both anxiety and cognitive symptoms more effectively.

4. Potential for Other Conditions: If your cognitive symptoms persist despite treatment for anxiety, it may warrant further investigation into other potential causes. Conditions such as attention deficit hyperactivity disorder (ADHD), depression, or even early signs of neurodegenerative diseases could contribute to the cognitive difficulties you are experiencing. A comprehensive evaluation by a neurologist or psychiatrist specializing in cognitive disorders may provide additional insights.

5. Conclusion and Recommendations: It is essential to maintain open communication with your healthcare provider about your symptoms and treatment responses. If benzodiazepines are not effective, discussing alternative medications or therapies is crucial. Additionally, lifestyle modifications, such as regular exercise, a balanced diet, and mindfulness practices, can also support cognitive function and overall mental health.
In summary, while benzodiazepines can help manage anxiety, their effectiveness in treating cognitive symptoms is limited. If your symptoms persist, further evaluation and a tailored treatment approach may be necessary to address the underlying causes effectively.

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