Many people take medications like alprazolam (Xanax) to help with anxiety or trouble sleeping. Alprazolam belongs to a group of drugs called benzodiazepines. These medications help calm the brain. But some doctors are asking an important question: Could these drugs affect memory or even lead to dementia?

Let’s take a close look at what scientists and doctors know right now about how benzodiazepines affect cognitive function — the brain’s ability to think, learn, remember, and make decisions.

What Are Benzodiazepines?

Benzodiazepines are drugs that help with several conditions. They work by increasing a chemical in the brain called gamma-aminobutyric acid (GABA), which slows down brain activity. This makes people feel calm, relaxed, and sleepy.

Benzodiazepines are often used to treat:

• Anxiety
• Panic attacks
• Trouble sleeping
• Seizures
• Muscle spasms

There are many benzodiazepine medications. Some well-known benzodiazepines include:

• Alprazolam
• Clonazepam (Klonopin)
• Diazepam (Valium)
• Lorazepam (Ativan)
• Temazepam (Restoril)

These medications can be very helpful in the short term. But they also come with risks, especially when used for a long time.

What Is Dementia?

Dementia is not a single disease. It’s a group of problems that affect memory, learning, thinking, and decision-making. The most common kind of dementia is Alzheimer’s disease, but there are other types, too.

Dementia is more common in older adults, especially people over 65. It tends to get worse over time. Some signs of dementia include:

• Forgetting names or events
• Getting lost in familiar places
• Having trouble with speaking or writing
• Experiencing mood changes or confusion

Doctors and scientists are still learning what causes dementia. Age, family history, head injuries, and certain health problems can all raise your risk.

Can Xanax or Other Benzodiazepines Cause Dementia?

Doctors have been asking this question for years. The answer isn’t simple. But here’s what we know so far.

Some Studies Say Yes

Several studies have found a possible link between benzodiazepine use and dementia. One major study looked at older adults in Canada. People who used benzodiazepines for more than 90 days had a higher risk of developing Alzheimer’s than those who didn’t. The risk increased the longer they used the drugs. Another study in Finland found a similar pattern. People with Alzheimer’s were more likely to have used benzodiazepines in the past.

Some researchers think these drugs may affect brain cells or sleep cycles in a way that speeds up memory loss. Others believe that benzodiazepines don’t cause dementia but instead uncover early symptoms in people who were already at risk.

Other Studies Say No

Not all researchers agree. Some studies suggest the connection may not be as strong as once thought. A 2015 study did not find strong evidence that benzodiazepines cause Alzheimer’s or other dementias. The authors said earlier studies might not have considered other health problems that lead to both anxiety and memory loss. A review from 2022 said that when benzodiazepines were used responsibly, there was no increased risk of dementia in older adults.

This disagreement shows that more research is needed. Scientists still don’t fully understand how benzodiazepines affect the brain over many years.

Do Benzodiazepines Cause Memory Loss or Confusion?

Even if they don’t cause dementia, these drugs can cause memory and cognitive problems, especially in older people or when used long term.

Some common short-term side effects of benzodiazepines include:

• Sleepiness or drowsiness
• Confusion
• Slower breathing
• Fainting or “passing out”
• Forgetfulness

These symptoms often go away after stopping the drug. But some people — especially older adults — may notice these side effects last for weeks or even months.

A 2020 study warned that long-term use of benzodiazepines might increase confusion and memory problems, even in people who never develop dementia.

How Might These Drugs Affect the Brain?

Some scientists believe that benzodiazepines may cause brain changes that lead to memory loss. Keep reading for possible explanations.

Reduced Brain Plasticity

Benzodiazepines can cause reduced brain plasticity. This means your brain has a harder time making new connections, which is important for learning and memory.

Poorer Sleep Quality

These drugs change how much deep sleep you get, which may affect how your brain stores memories. Deep sleep is important for learning and memory, so getting too little deep sleep could make it harder to remember things over time.

Increased Inflammation

Some theories suggest that long-term use of benzodiazepines could increase inflammation in brain cells, which may lead to damage. This kind of damage might affect cognitive skills over time.

What if You Have a Family History of Dementia?

If your parent, grandparent, or sibling has had Alzheimer’s or another type of dementia, you may be more likely to get it too. That doesn’t mean you definitely will — but it’s something to be aware of.

So, is it safe to take benzodiazepines if you have this risk? Most doctors recommend caution. Here are some steps you can take to minimize your risks:

• Use benzodiazepines only for short periods.
• Try safer treatments first.
• Tell your doctor about your family history.
• Get regular memory checkups.

Doctors also recommend avoiding medications that make memory worse, including benzodiazepines, especially if you’re already at risk. You may have seen news headlines linking certain drugs to dementia or Alzheimer’s, including common medications like statins or allergy medicines. That’s why it’s important to tell your healthcare team about everything you’re taking, so they can make the best decision based on your overall health.

Are There Better Options for Managing Anxiety?

Yes. Benzodiazepines are not the only way to manage anxiety. Most doctors today suggest other treatments first. If you’re just starting treatment for anxiety, ask your healthcare provider about other options like therapy, antidepressants, or natural approaches like mindfulness and exercise. These choices are often just as effective and may be better for your brain in the long run.

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a type of talk therapy that helps people understand and change the thoughts that cause anxiety. It teaches healthy ways to manage stress, and it doesn’t cause memory problems.

Antidepressants for Anxiety

Some antidepressants, like sertraline (Zoloft) and escitalopram (Lexapro), are also used to treat anxiety. They take a few weeks to work but are safe for long-term use. Unlike benzodiazepines, they don’t carry the same risks for memory or thinking.

Mindfulness and Lifestyle Changes

Regular exercise, meditation, and good sleep habits can all help reduce anxiety. These healthy routines support your brain and body in staying calm. Many people find that these changes lower anxiety naturally over time.

Other Medications

Doctors sometimes use other medicines like buspirone or hydroxyzine to treat anxiety. These drugs can be good choices for people who want to avoid benzodiazepines. They work without causing memory loss or drowsiness in most people.

Should You Stop Taking Xanax?

If you’re already taking alprazolam or a similar medication, do not stop suddenly. Benzodiazepines can cause withdrawal symptoms, such as:

• Sweating
• Trembling
• Trouble sleeping
• Anxiety or panic
• Seizures (in rare cases)

If you’re taking alprazolam or another benzodiazepine, the most important step is to talk to your doctor. They can help you gradually lower your dose or find a safer alternative, depending on what’s best for your health.

Keeping a medication journal can help. Write down how you feel each day. Tracking your symptoms can make it easier for you and your doctor to see whether the medicine is helping or causing side effects.

Talk With Others Who Understand

On MyAlzTeam, the social network for people with Alzheimer’s disease and their loved ones, more than 86,000 members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s disease.

Have you thought about taking a benzodiazepine for anxiety? Share your experience in the comments below, or start a conversation by posting on your Activities page.