Abstract
Rationale
Oculomotor balance and contrast sensitivity are known to be impaired after an intake of a single dose of lorazepam. To the best of our knowledge, these effects have not been explored in long-term users of lorazepam, despite the potential importance of such deficits in everyday life.
Objective
We tested the ophthalmological effects and contrast sensitivity for static stimuli in long-term lorazepam users.
Materials and methods
There were 15 lorazepam users and 15 sex-, age- and education level-matched control subjects tested, using a simple blind procedure.
Results
The ophthalmological effects were scarce, with a discrete exophoria. Visual acuity was preserved. Contrast sensitivity, however, was more markedly impaired, consistent with the effects of an acute dose of lorazepam. The effects were not correlated with anxiety or sedation.
Conclusions
The results are discussed in terms of their possible impact on everyday life. As visual acuity does not allow the detection of the impairments that are observed in the present study, it is suggested that a more systematic exploration of contrast sensitivity be carried out in long-term users of benzodiazepines.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aranko K, Mattila MJ, Nuutila A, Pellinen J (1985) Benzodiazepines, but not antidepressants or neuroleptics, induce dose-dependent development of tolerance to lorazepam in psychiatric patients. Acta Psychiatr Scand 72:436–446
Beckers T, Wagemans J, Boucart M, Giersch A (2001) Different effects of lorazepam and diazepam on perceptual integration. Vision Res 41:2297–2303
Biedermann B, Bringmann A, Franze K, Faude F, Wiedemann P, Reichenbach A (2004) GABAA receptors in Müller glial cells of the human retina. Glia 46:302–310
Blin O, Mestre D, Paut O, Vercher JL, Audebert C (1993) GABA-ergic control of visual perception in healthy volunteers: effects of midazolam, a benzodiazepine, on spatio-temporal contrast sensitivity. Br J Clin Pharmacol 36:117–124
Bond A, Lader M (1974) The use of analogue scales in rating subjective feelings. Br J Med Psychol 47:211–218
Brown J, Lewis V, Brown M, Horn G, Bowes JB (1982) A comparison between transient amnesias induced by two drugs (diazepam and lorazepam) and amnesia of organic origin. Neuropsychologia 20:55–70
Brown MW, Brown J, Bowes JB (1989) Absence of priming coupled with substantially preserved recognition in lorazepam-induced amnesia. Q J Exp Psychol 41A:599–617
Curran HV, Barrow S, Weingartner H, Lader M, Bernik M (1995) Encoding, remembering and awareness in lorazepam-induced amnesia. Psychopharmacology (Berl) 122:187–193
Curran HV, Collins R, Fletcher S, Kee SCY, Woods B, Iliffe S (2003) Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life. Psychol Med 33:1223–1237
Danion JM, Peretti S, Grangé D, Bilik M, Imbs JL, Singer L (1992) Effects of chlorpromazine and lorazepam on explicit memory, repetition priming and cognitive skill learning in healthy volunteers. Psychopharmacology (Berl) 108:345–351
Di Lazzaro V, Pilato F, Dileone M, Tonali PM, Ziemann N (2005) Dissociated effects of diazepam and lorazepam on short-latency afferent inhibition. J Physiol 569:315–323
Elliott M, Giersch A, Seifert D (2006) Some facilitatory effects of lorazepam on dynamic visual binding. Psychopharmacology (Berl) 184:229–238
Giersch A, Herzog M (2004) Lorazepam strongly prolongs visual information processing. Neuropsychopharmacology 29:1386–1394
Giersch A, Vidailhet P (2006) Dissociation between perceptual processing and priming in long-term lorazepam users. Int J Neuropsychopharmacol (doi:10.1017/S1461145705006322)
Golombok S, Moodley P, Lader M (1988) Cognitive impairment in long-term benzodiazepine users. Psychol Med 18:365–374
Gorenstein C, Bernik MA, Pompéia S, Marcourakis T (1995) Impairment of performance associated with long-term use of benzodiazepines. J Psychopharmacol 9:313–318
Gresset J, Boisjoly H, Nguyen TQ, Boutin J, Charest M (1997) Validation of French-language versions of the visual functioning index (VF-14) and the Cataract Symptom Score. Can J Ophthalmol 32:31–37
Groner M, Fisch HU, Walder F, Groner R, Hofer D, Koelbing U, Duss I, Bianchi R, Bircher B (1992) Specific effects of the benzodiazepine midazolam on visual receptive fields in light and dark adapted human subjects. Psychopharmacology (Berl) 109:68–76
Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32:50–55
Harris JP, Phillipson OT (1995) Effects of lorazepam on human contrast sensitivity. Psychopharmacology (Berl) 117:379–384
Kao YH, Lassová L, Bar-Yehuda T, Edwards RH, Sterling P, Vardi N (2004) Evidence that certain retinal bipolar cells use both glutamate and GABA. J Comp Neurol 478:207–218
Knopman D (1991) Unaware learning versus preserved learning in pharmacologic amnesia: similarities and differences. J Exp Psychol Learn Mem Cogn 17:1017–1029
Legrand F, Vidailhet P, Danion JM, Grangé D, Giersch A, Van Der Linden M, Imbs JL (1995) Time course of the effects of diazepam and lorazepam on perceptual priming and explicit memory. Psychopharmacology (Berl) 118:475–479
Lüdtke H, Wilhelm M, Adler F, Schaeffel H, Wilhelm H (1998) Mathematical procedures in data recording and processing of pupillary fatigue waves. Vision Res 38:2889–2996
Maddock RJ, Casson EJ, Lott LA, Carter CS, Johnson CA (1993) Benzodiazepine effects on flicker sensitivity: role of stimulus frequency and size. Prog Neuropsychopharmacol Biol Psychiatry 17:955–970
Martin J, Matthews A, Martin F, Kirkby KC, Alexander J, Daniels B (2002) Effects of lorazepam and oxazepam on perceptual and procedural memory functions. Psychopharmacology (Berl) 164:262–267
Petursson H, Gudjonsson GH, Lader MH (1983) Psychometric performance during withdrawal from long-term benzodiazepine treatment. Psychopharmacology (Berl) 81:345–349
Pichot P, Pull CB, von Frenckell R, Pull MC (1981) Une analyse factorielle de l’échelle d’appréciation de l’anxiété de Hamilton. Psychiat Fennica, International edition, pp 183–189
Pompeia S, Bueno OF, Galduroz JC, Tufik S (2003) Stem-completion tasks (indirect, direct inclusion and exclusion) are differently affected by equipotent doses of lorazepam and flunitrazepam. Hum Psychopharmacol 18:541–549
Schaeffel F, Wilhelm H, Zrenner E (1993) Inter-individual variability in the dynamics of natural accommodation in humans: relation to age and refractive errors. J Physiol 461:301–320
Sellal F, Danion JM, Kauffmann-Muller F, Grangé D, Imbs JL, Van Der Linden M, Singer L (1992) Differential effects of diazepam and lorazepam on repetition priming in healthy volunteers. Psychopharmacology (Berl) 108:371–379
Speeg-Schatz C, Giersch A, Boucart M, Gottenkiene S, Tondre M, Kauffmann-Muller F, Danion JM (2001) Visual effects of lorazepam on the oculomotor balance. Binocul Vis Strabismus Q 16:99–104
Vardi N, Sterling P (1994) Subcellular localization of GABAA receptor on bipolar cells in macaque and human retina. Vision Res 34:1235–1246
Vidailhet P, Danion JM, Kauffman-Muller F, Grangé D, Giersch A, Van Der Linden M, Imbs JL (1994) Lorazepam and diazepam effects on memory acquisition in priming tasks. Psychopharmacology (Berl) 115:397–406
Vidailhet P, Danion JM, Chemin C, Kazès M (1999) Lorazepam impairs both visual and auditory perceptual priming. Psychopharmacology (Berl) 147:266–273
Acknowledgements
This research was financed by the University Hospital of Strasbourg (PHRC) and by INSERM. We thank Catherine Kleitz, Jean-Charles Barthaud, and Natacha Candelier for their invaluable help in testing patients.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Giersch, A., Speeg-Schatz, C., Tondre, M. et al. Impairment of contrast sensitivity in long-term lorazepam users. Psychopharmacology 186, 594–600 (2006). https://doi.org/10.1007/s00213-006-0378-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00213-006-0378-3