Written by Valerie Jones, MD | Reviewed by Katie E. Golden, MD Updated on September 12, 2022
Key takeaways:
- Many Americans take Xanax (alprazolam) to help with anxiety and sleep. But it has side effects that can affect memory.
- People may have problems making new memories while Xanax is active in their system. This means they may forget events that occurred after taking the medication.
- There’s no solid evidence to suggest that Xanax causes dementia. But, in older adults, its effects on memory may last longer and be more pronounced.
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In the past year, almost 13% of Americans reported using benzodiazepines — like Xanax (alprazolam). Among these people, 80% take it for anxiety, and 20% take it for insomnia. But the way that benzodiazepines affect the brain means they can also affect memory. And when people experience these side effects — particularly older adults — it can lead to concerns about dementia.
We’ll explain exactly how Xanax and other benzodiazepines affect memory. We’ll also cover what the science says about its connection to long-term conditions like dementia.
How does Xanax affect memory?
Xanax (alprazolam) is a type of benzodiazepine, a group of medications that mainly treats anxiety disorders. But their calming effect comes with some side effects. Xanax and other benzodiazepines also affect mental processing speed, attention, memory, and physical activity. In particular, benzodiazepines can cause loss of memory (amnesia) of events that occur while the medication is in your system.
Xanax works by attaching to GABA receptors in the brain that slow down the release of certain brain chemicals (neurotransmitters) in nearby areas. The result is a general decrease in brain signals, causing drowsiness and forgetfulness. This wears off as you metabolize the medication. Your body can take anywhere from 6 to 20 hours to remove just half of a Xanax dose. And your body takes much longer than that (4 to 5 times as long) to completely remove the medication.
Can Xanax cause short-term memory loss?
Xanax can cause memory loss while it’s still active in the body. This is especially true during that window (about 6 to 20 hours) when over half the dose is still in your system. During this time, memory gaps can occur. You may forget events or conversations that happened after taking a dose of Xanax, similar to the way people have trouble remembering their dreams.
And it’s important to note that other benzodiazepines — like diazepam (Valium) — can last even longer. As a comparison, the body takes 20 to 100 hours to excrete half the dose of diazepam.
Do benzodiazepines cause dementia?
There’s no solid evidence that says benzodiazepines cause dementia. But there’s still a possible link between the two. Researchers are still trying to understand their connection.
One study found a link between long-term benzodiazepine use and ongoing memory problems. But another study suggests that these longer term memory problems are very small, and they would probably go unnoticed without testing by a brain specialist.
But even if there is a connection between memory loss and benzodiazepines, it doesn’t necessarily mean that the medications caused the memory loss. Alzheimer’s disease and dementia can cause anxiety, so people with these conditions are more likely to get treatment for anxiety than their peers. So it’s possible that people with memory loss and dementia are more likely to take benzodiazepines because they’re also more likely to have anxiety. In this scenario, the medication isn’t the cause of the memory loss.
Experts are clear on one thing: Older adults are at higher risk for unwanted side effects from benzodiazepines. And these side effects include memory changes. But even though there’s overlap between the symptoms of dementia and the effects of benzodiazepines, it’s important to note that the underlying cause is different.
Dementia is caused by slow damage to the brain over years — from things like clogged blood vessels, strokes, and head injuries. People with dementia have permanent difficulties with forming new memories, personality changes, and difficulty with basic activities of daily living. This is different from the way benzodiazepines change receptors and chemicals in the brain.
Can benzodiazepine addiction affect memory?
Even if someone is addicted to benzodiazepines, it appears that long-term memory impairments do not remain after benzodiazepines leave the system. This may not be the case for older adults, though negative effects are small. Aging slows the body’s ability to remove drugs from the bloodstream, so many medications stick around longer and cause stronger side effects. In the case of Xanax, this may mean longer periods of forgetfulness and drowsiness that can affect safe driving and increase the risk of falls.
Is memory loss from Xanax reversible?
Yes. Current research suggests that it’s largely reversible. People over the age of 65 may be at a slightly higher risk for ongoing memory deficits even after stopping benzodiazepines, though these memory deficits are relatively mild.
In many cases, people who take Xanax don’t know that it can cause temporary difficulty with forming new memories. This may cause concern about having a serious condition like dementia. The good news is that once you stop taking the medication for several days, these effects on memory should go away.
If you’re considering Xanax for anxiety, know that experts recommend other anti-anxiety medications before benzodiazepines. And if you’re taking Xanax and want to stop taking it, be aware that long-term use increases the risk of withdrawal symptoms. You can reduce withdrawal by slowly decreasing or tapering the medication before completely stopping it. Be sure to discuss this process with your healthcare provider.
The bottom line
Xanax is a benzodiazepine that helps many people with their anxiety symptoms. But it comes with risks, including memory gaps. And these risks may be greater in older adults because they process the medication a little differently. The good news is these effects are reversible when you stop taking the medication. To avoid these side effects, talk to your provider about alternative treatments that might be safer.
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