title: [Remote consequences of the long-term uncontrolled use of anxiolytic and hypnotic drugs by elderly patients: cognitive disorders].
abstract: OBJECTIVE
  Frequents cases (10-30% of the elderly population) of regular long-term use of anxiolytic and hypnotic drugs, in particular, benzodiazepines, without control of the physician is an urgent problem of medicine worldwide. Severe and irreversible cognitive impairment is a frequent and severe consequence of this use. Authors studied cognitive impairment in these cases.
  
  
  METHODS
  Patients were enrolled in the study from a psychiatric hospital. The study included 56 women, aged over 50 years, admitted to the hospital with the diagnosis of a mental disorder. Before admission, the patients regularly used benzodiazepines without a prescription for more than 2 months. Later on, anxiolytics were withdrawn during 1-5 days. The patients were studied during 4 weeks in the hospital. To assess the severity and dynamics of their condition, authors used MADRS, HAM-A, MMSE.
  
  
  CONCLUSIONS
  Severe cognitive impairment, achieving the level of dementia, was found in 57.2% of the patients, mild or moderate of cognitive impairment was in 32.1% and only 10.7% had normal level of cognitive functioning. After 4 weeks of benzodiazepine withdrawal, the percentage of patients with dementia reduced to 21.4%, the severity of cognitive impairment was estimated as mild or moderate. A number of patients without cognitive impairment increased to 37.5%. The old age of patients was a significant negative predictor of the dynamics. An impact of the high anxiolytic dose was shown on trend level. The duration of a mental disorder and duration of uncontrollable consumption of anxiolytics and hypnotics did not exert an effect on the development and reversibility of cognitive impairment. A combination of anxiolytics with alcohol increased the risk of dementia and did not reverse the cognitive pathology.
authors.affiliation: Kafedra psihiatrii i narkologii GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva, Nauchno-issledovatel'skij otdel 'Psihicheskogo zdorov'ja' Nauchno-issledovatel'skogo tsentra GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva.
authors.forename: N N
authors.initials: NN
authors.lastname: Ivanets
authors.affiliation: Kafedra psihiatrii i narkologii GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva, Nauchno-issledovatel'skij otdel 'Psihicheskogo zdorov'ja' Nauchno-issledovatel'skogo tsentra GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva.
authors.forename: M A
authors.initials: MA
authors.lastname: Kinkulkina
authors.affiliation: Kafedra psihiatrii i narkologii GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva, Nauchno-issledovatel'skij otdel 'Psihicheskogo zdorov'ja' Nauchno-issledovatel'skogo tsentra GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva.
authors.forename: T I
authors.initials: TI
authors.lastname: Avdeeva
authors.affiliation: Kafedra psihiatrii i narkologii GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva, Nauchno-issledovatel'skij otdel 'Psihicheskogo zdorov'ja' Nauchno-issledovatel'skogo tsentra GBOU VPO 'Pervyj Moskovskij gosudarstvennyj meditsinskij universitet im. I.M. Sechenova' Minzdrava RF, Moskva.
authors.forename: V P
authors.initials: VP
authors.lastname: Sysoeva
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects*; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D003704:Dementia / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D004363:Drug Utilization; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D028761:Withholding Treatment
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines