Careful Interpretation of Research on Seizure Medications

Epilepsy News From: Wednesday, September 17, 2014

Community Corner: September 17, 2014

Recent news reported early results of a study evaluating the risks of benzodiazepines and development of Alzheimer’s, a form of dementia. This preliminary report, published in the British Medical Journal, has generated many news stories that suggest using benzodiazepines could be harmful, especially when used long term.

Benzodiazepines are a group of medicines that can be used for many symptoms and problems. For example, they are used to treat mood disorders, sleep problems, behavioral problems associated with other conditions, muscle spasms or tension, and seizures. When used to treat seizures, they are most often used intermittently for clusters of seizures, but some may be used on a daily basis. Examples of benzodiazepines used to treat seizures include diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), rectal diazepam (Diastat), and Clobazam (Onfi).

A few points about the study:

  • The authors looked at claims data (billing reports for medical care) from patients in Quebec, Canada for at least 6 years.
  • Data from 1,796 elderly people diagnosed with Alzheimer’s Disease was compared to 7,184 healthy people.
  • A higher risk for developing Alzheimer’s Disease was found in people whose claims data showed past use of benzodiazepines. The link appeared stronger in people who used the medications longer.
  • Some other medical conditions were looked at in relation to benzodiazepine use, but not epilepsy.
  • No conclusions about use of benzodiazepines in younger people or for epilepsy were noted.

What does this report mean for people with epilepsy?

Dr. Nathan Fountain, chair of the Epilepsy Foundation’s Professional Advisory Board, was asked for his thoughts on the study.

  • “The findings are very preliminary but suggest that benzodiazepines should be used carefully in older people. The study results can not be generalized to middle-aged adults or children with epilepsy, because the study did not look at younger ages or when benzodiazepines are given specifically for epilepsy.”
  • “Benzodiazepines are not the first choice of treatment for epilepsy but are used when other drugs don’t work. Some are also used as rescue therapies for clusters, prolonged seizures or to treat seizure emergencies. We do not have evidence that these medications cause dementia in these situations.”
  • Most importantly, Dr. Fountain cautioned that “people with epilepsy who have seizures controlled by these drugs (one of the benzodiazepine medications) should NOT stop taking them as a result of this research. The risk of these drugs causing problems is unknown but the benefit is likely to be great. It is also important for people to know that suddenly stopping one of these medications can lead to a worsening of seizures.”

Summary

Research can help us learn more about many conditions, but can also lead to confusion. The study discussed here found important suggestions about Alzheimer’s Disease, but the results do not give evidence about the use of these medications for epilepsy.

The common advice about any news is especially important here:

  • When you hear about news relating to seizures, new treatments or safety concerns, always share this with your doctor or health care provider.
  • Make sure you understand what the report means and if it relates to you.
  • And don’t make changes in your treatment without the advice of your treating provider!

Wishing you all a safe week!

Patricia Osborne Shafer RN, MN
Associate Editor/Community Manager

Authored by

Patty Obsorne Shafer RN, MN

Reviewed Date

Wednesday, September 17, 2014

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