title: Use of Benzodiazepines in Alzheimer's Disease: A Systematic Review of Literature.
abstract: BACKGROUND
  Benzodiazepines are frequently prescribed in patients with Alzheimer's disease. Unfortunately, studies evaluating their benefits and risks in these patients are limited.
  
  
  METHODS
  Clinical trials focusing on the effect of benzodiazepines on cognitive functions, disease progression, behavioral symptoms, sleep disturbances, and the general frequency of benzodiazepine use were included in this review. Published articles from January 1983 to January 2015 were identified using specific search terms in MEDLINE and PubMed Library according to the recommendations of The Strengthening the Reporting of Observational Studies in Epidemiology initiative.
  
  
  RESULTS
  Of the 657 articles found, 18 articles met predefined selection criteria and were included in this review (8 on frequency, 5 on cognitive functions, 5 on behavioral and sleep disturbances). The frequency of benzodiazepine use ranged from 8.5% to 20%. Five studies reported accelerated cognitive deterioration in association with benzodiazepine use. Two studies reported clinical efficacy for lorazepam and alprazolam to reduce agitation in Alzheimer's disease patients. No evidence was found for an improvement of sleep quality using benzodiazepines.
  
  
  CONCLUSIONS
  This systematic review shows a relatively high prevalence of benzodiazepine use but limited evidence for clinical efficacy in Alzheimer's disease patients. However, there is a paucity of methodologically high quality controlled clinical trials. Our results underscore a need for randomized controlled trials in this area.
authors.affiliation: Memory Clinic (Dr Defrancesco), and Division of General and Social Psychiatry (Drs Fleischhacker and Blasko), Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria; Department of Psychiatry and Psychotherapy A, Landeskrankenhaus Hall, Hall, Austria (Dr Marksteiner); Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria (Dr Fleischhacker).
authors.forename: Michaela
authors.initials: M
authors.lastname: Defrancesco
authors.affiliation: Memory Clinic (Dr Defrancesco), and Division of General and Social Psychiatry (Drs Fleischhacker and Blasko), Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria; Department of Psychiatry and Psychotherapy A, Landeskrankenhaus Hall, Hall, Austria (Dr Marksteiner); Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria (Dr Fleischhacker).
authors.forename: Josef
authors.initials: J
authors.lastname: Marksteiner
authors.affiliation: Memory Clinic (Dr Defrancesco), and Division of General and Social Psychiatry (Drs Fleischhacker and Blasko), Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria; Department of Psychiatry and Psychotherapy A, Landeskrankenhaus Hall, Hall, Austria (Dr Marksteiner); Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria (Dr Fleischhacker).
authors.forename: W Wolfgang
authors.initials: WW
authors.lastname: Fleischhacker
authors.affiliation: Memory Clinic (Dr Defrancesco), and Division of General and Social Psychiatry (Drs Fleischhacker and Blasko), Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria; Department of Psychiatry and Psychotherapy A, Landeskrankenhaus Hall, Hall, Austria (Dr Marksteiner); Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria (Dr Fleischhacker).
authors.forename: Imrich
authors.initials: I
authors.lastname: Blasko
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D001569:Benzodiazepines / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D011619:Psychotropic Drugs; D001569:Benzodiazepines
keywords: Alzheimer’s disease; Benzodiazepines; agitation; behavioral and psychological symptoms of dementia; sleep disorder