Sedative-, Hypnotic-, or Anxiolytic-Induced Persisting Amnestic Disorder: An Overview
The use of sedatives, hypnotics, and anxiolytics have been associated with the development of a range of cognitive deficits, including Persisting Amnestic Disorder (PAD). This review will provide an overview of the current literature on sedative-, hypnotic-, or anxiolytic-induced PAD, which is defined as a cognitive disorder characterized by anterograde and/or retrograde memory impairment resulting from the use of these medications.
PAD is most commonly associated with benzodiazepines, which are a class of sedative-hypnotic medications used for the short-term treatment of anxiety and insomnia. The long-term use of benzodiazepines has been associated with anterograde amnesia, which is a diminished ability to create new memories. Retrograde amnesia, or the inability to recall memories before the onset of benzodiazepine use, has also been reported in some cases. Other sedative-hypnotic medications, such as barbiturates and antihistamines, have also been associated with PAD, although the prevalence of this disorder is highest among benzodiazepine users.
The mechanism by which benzodiazepines cause PAD is not fully understood, but several hypotheses have been proposed. One hypothesis is that benzodiazepines interfere with the formation of long-term memories by disrupting the storage and retrieval of information. Another hypothesis is that benzodiazepines disrupt the formation of new memories by impeding the process of reconsolidation, which is the process by which memories are consolidated and stored in the brain. Finally, it has been suggested that benzodiazepines may disrupt the hippocampus, which is the brain region responsible for memory formation.
The diagnosis of PAD is based on a comprehensive clinical evaluation, which includes a detailed review of the patient’s medical and medication histories, as well as a physical and neurological examination. In addition, laboratory tests, such as neuroimaging and neuropsychological testing, may be used to assess memory function and identify any areas of cognitive impairment. Treatment of PAD typically involves the gradual tapering of the offending medication, as well as the use of cognitive-behavioral therapies and other strategies to address the underlying psychological issues that may be contributing to the memory deficits.
In conclusion, PAD is a cognitive disorder associated with the use of sedatives, hypnotics, and anxiolytics, and is characterized by anterograde and/or retrograde memory deficits. Although the exact mechanism by which these medications cause PAD is not fully understood, it is important to recognize the potential for cognitive impairment in individuals taking these medications. It is also important to note that PAD is a treatable disorder, and that appropriate interventions can help individuals to regain and maintain their memory functioning.
References
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U.S. National Library of Medicine. (2018). Persistent amnestic disorder. MedlinePlus. https://medlineplus.gov/ency/article/000715.htm