Do Benzodiazepines Impair Motor and Nonmotor Symptoms in a Sample of Parkinson’s Disease Patients?

Wendy Gaztanaga,Carlos Singer,Henry Moore,Bonnie Levin,Corneliu Luca,Jason Margolesky,Jonathan Jagid,Marina Sarno

doi:10.7759/cureus.13220

Abstract

BackgroundAnxiety and sleep disturbances are prevalent in Parkinson’s disease (PD). Benzodiazepines (BZDs) are commonly used to treat these symptoms; however, they are associated with unfavorable side effects such as falls and cognitive slowing in the general non-PD population. Examining the effects of BZDs in PD is imperative as these medications could pose an increased risk to PD patients who are already vulnerable to falls and cognitive deficits.MethodsEighty-four patients diagnosed with idiopathic PD, of which 60% were Hispanic, underwent clinical evaluations including the Unified Parkinson’s Disease Rating Scale (UPDRS) and comprehensive neuropsychological testing examining global cognition, language, visuospatial skills, memory, executive function, mood, and sleep quality. Thirty-six patients taking BZDs (BZD+) were compared to forty-eight patients not using any BZDs (BZD-) employing appropriate statistical tests depending on the measures’ characteristics.ResultsBZD+ PD patients performed below the BZD- group on short-term memory but not on delayed recall, and performed better on a measure of visuospatial judgment. The BZD+ group endorsed more symptoms of anxiety and depression as well as poorer sleep quality. No significant differences were noted on other measures of cognition or motor function.ConclusionPD patients taking BZDs may experience select changes in cognition and mood. These changes are isolated and mild, and suggest that for some patients, BZDs may be a viable pharmacologic intervention that does not alter cognitive and motor function compared to those not taking these medications.

Highlights

Non-motor symptoms such as anxiety and sleep disturbances are highly prevalent in Parkinson’s disease (PD) [1, 2]
BZD+ PD patients performed below the BZD- group on short-term memory but not on delayed recall, and performed better on a measure of visuospatial judgment
Given that PD patients are, overall, at increased risk of falls and poorer cognitive outcomes compared to the general population, we examined whether PD patients using BZDs would exhibit more impaired cognition and increased risk of falling compared to PD patients not using these sedatives

Summary

Introduction

Non-motor symptoms such as anxiety and sleep disturbances are highly prevalent in Parkinson’s disease (PD) [1, 2]. Studies have found that 20-50% of PD patients have anxiety and as many as 90% of PD patients report experiencing sleep disturbances [1] Sedatives such as benzodiazepines (BZD) are commonly used to treat these symptoms in PD patients [2, 3]. Benzodiazepines (BZDs) are generally thought to increase the risk of falls and cognitive impairment, in the elderly [4]. Benzodiazepines (BZDs) are commonly used to treat these symptoms; they are associated with unfavorable side effects such as falls and cognitive slowing in the general non-PD population. Examining the effects of BZDs in PD is imperative as these medications could pose an increased risk to PD patients who are already vulnerable to falls and cognitive deficits

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