The DOI matches its Crossref record; 33 of the 34 references it cites were found in a registry or an index; none of the 17 sources its claims cite is checked for support yet.
Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis
Abstract
Despite the widespread prescribing of benzodiazepines, uncertainty still surrounds the potential for cognitive impairment following their long-term use. Furthermore, the degree of recovery that may take place after withdrawal or the level of residual impairment, if any, that is maintained in long-term benzodiazepine users is also unclear. The current paper employed meta-analytic techniques to address two questions: (1) Does the cognitive function of long-term benzodiazepine users improve following withdrawal? (2) Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data? Results of the meta-analyses indicated that long-term benzodiazepine users do show recovery of function in many areas after withdrawal. However, there remains a significant impairment in most areas of cognition in comparison to controls or normative data. The findings of this study highlight the problems associated with long-term benzodiazepine therapy and suggest that previous benzodiazepine users would be likely to experience the benefit of improved cognitive functioning after withdrawal. However, the reviewed data did not support full restitution of function, at least in the first 6 months following cessation and suggest that there may be some permanent deficits or deficits that take longer than 6 months to completely recover.
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Claims the paper makes
30 Own result · 18 Own interpretation · 9 No full text of the sources · 6 Own method · 5 Sources not found · 3 No basis given · 1 Not checked yet
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Weighting for sample size had little impact on the effect size (0.42 unweighted compared to 0.40 weighted, meta-analysis A; -0.41 unweighted compared to -0.48 weighted, meta-analysis B)”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An analyses conducted on moderator variables did not reveal any significant relationships.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, there remains a significant impairment in most areas of cognition in comparison to controls or normative data.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean weighted effect size was 0.41 (median = 0.37) with a standard deviation of 0.22.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.1. Meta-analysis A: Does the cognitive function of long-term benzodiazepine users improve following withdrawal?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In meta-analysis A, effect sizes greater than zero were found across all cognitive domains measured”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The significant negative correlation, between age and overall effect size, suggests that improvement in attention/concentration after withdrawal decreases as age increases.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Negative effect sizes were found across 11 of the 12 cognitive categories in meta-analysis B”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results of the meta-analyses indicated that long-term benzodiazepine users do show recovery of function in many areas after withdrawal.”
- Also stated in: § 2.1. Meta-analysis A: Does the cognitive function of long-term benzodiazepine users improve following withdrawal? · hedged
“Compared to their initial assessment, previous long-term benzodiazepine users appeared to improve across all cognitive categories examined at follow-up assessment.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > Abstract
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § 2.1. Meta-analysis A: Does the cognitive function of long-term benzodiazepine users improve following withdrawal? · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the reviewed data did not support full restitution of function, at least in the first 6 months following cessation”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared to controls or norms, previous long-term benzodiazepine users performed more poorly across all cognitive categories, except sensory processing, when examined at follow-up assessment.”
- Also stated in: § 3. Discussion · hedged
“suggesting that, except for sensory processing, patients who had withdrawn from long-term benzodiazepine use continued to perform more poorly than controls (or normative data) at follow-up.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § 3. Discussion · hedged
- Probably not a substantial claim. 16
- It may state two separate claims as one. 23
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One trend of interest was a relationship between publication year and overall effect size, such that studies published later than 1994 tended to have larger effect sizes.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean weighted effect size was -0.48 (median = 0.48) with a standard deviation of 0.45.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The studies included in these meta-analyses were all published in peer-reviewed journals.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The fail-safe n, which represents the number of studies obtaining null results that would need to be in existence to threaten the significant effect size found, was calculated to be four for meta-analysis A and five for meta-analysis B.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is clear from Fig. 2 that the 95% confidence intervals do not span zero for 8 of the 11 effect sizes and therefore, that most of these effects are significant and different to zero”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is clear from Fig. 1 that the 95% confidence intervals do not span zero for 5 of 11 effect sizes and therefore, that these effects are significant and different from zero”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.1. Meta-analysis A: Does the cognitive function of long-term benzodiazepine users improve following withdrawal?
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“From nine studies covering 12 categories (a maximum of 108 possible effect sizes), 37 effect sizes were obtained.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In the present meta-analyses, the tolerance level is estimated at 5(10) + 10 = 60 and 5(9) + 10 = 55 for meta-analyses A and B, respectively.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All of the effect sizes were positive and ranged in magnitude from 0.06 to 0.70.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.1. Meta-analysis A: Does the cognitive function of long-term benzodiazepine users improve following withdrawal?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Mean scale scores in four of these would be considered in the clinical range and two in the non-clinical range.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For example, the degree of recovery that appears to take place in the domain of attention/concentration is significant with a moderate to large effect size (d = 0.69), and a significant, small to moderate effect size (d = -0.43)indicating the level of residual impairment.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Seven out of 10 studies reported pre-and post-withdrawal anxiety or depression levels and in all of these, patient's symptoms either improved significantly or remained the same.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Six studies specified pre-and post-withdrawal psychiatric symptoms using a variety of subjective mood scales including the Spielberger State-Trait Anxiety Inventory, the Hamilton Anxiety Scale, the Hamilton Depression Scale, and the Beck Depression Inventory.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it was not possible to calculate effect sizes for all 12 categories as only one test within the problem-solving category was used”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Five studies specified the conditions for which subjects used benzodiazepines and for all five the conditions were anxiety or depression.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eight studies excluded patients with a history of heavy alcohol or other drug use and one study stated that 23% of patients had a history of alcohol use in excess of four standard drinks per day.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plainn = 8- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All six studies reported that mean scores either remained the same following withdrawal (four studies) or significantly improved (two studies).”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, it should be interpreted with caution due to the inflation in type I error rate associated with the number of analyses conducted.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and suggest that there may be some permanent deficits or deficits that take longer than 6 months to completely recover.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > Abstract
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“With regard to the coding of significance levels, a conservative approach was adopted.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 1.2. Criteria for inclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“According to Cohen (1988), effect sizes of d = 0.20, 0.50, and 0.80 are considered small, medium, and large in magnitude, respectively.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
What the sources say
- Not matchedcites Cohen (1988)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Each study was only allowed to contribute one effect size to each cognitive category by averaging together the effect sizes from the same study if more than one type of test was used to measure a particular category.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 1.2. Criteria for inclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Effect sizes were weighted on the basis of their sample size.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 1.4. Calculation of effect sizes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Rosenthal has suggested that a conservative estimate for this tolerance level is 5k + 10 where k is the number of studies retrieved.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
What the sources say
- Not matchedcites Rosenthal
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Since the fail-safe n falls short of the tolerance level, the possibility of a file drawer problem should be considered for both meta-analyses, and the resulting effect sizes interpreted with caution.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This finding may be related to deficits in performance on tasks of attention and concentration observed to accompany normal aging (Lezak, 1995).”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
What the sources say
- Not checked — no full text of the sourcecites Lezak, 1995
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In a previous meta-analysis that we have conducted looking at the long-term cognitive effects of benzodiazepine use (Barker, Greenwood, Jackson & Crowe, in press) we found moderate to large effect sizes across all cognitive areas studied indicating that long-term benzodiazepine users are impaired across many cognitive areas.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
What the sources say
- Not matchedcites Barker, Greenwood, Jackson & Crowe, in press
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This seems unlikely, however, given that the mean age in nine of the studies was between 39 and 47 years, and the remaining study, which examined mainly older adults, did in fact screen for and exclude patients with dementia.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It may be the case that some real differences do exist that were undetectable given the small sample size.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and suggests that there may be some permanent deficits or deficits that take periods longer than 6 months to completely recover.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Due to the small number of studies that met inclusion criteria in this meta-analysis, and the limited information provided on relevant characteristics, an analysis of heterogeneity (Q) (Hedges & Olkin, 1985) was considered inappropriate.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
What the sources say
- Not matchedcites Hedges & Olkin, 1985
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“Gorenstein et al.'s (1995) well-controlled comparison of neuropsychological test performance in anxious drug-free patients and normal controls found no significant difference in performance on a variety of neuropsychological tests except for a ball-bearing test measuring motor co-ordination.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
What the sources say
- Not checked — no full text of the sourcecites Gorenstein et al. (1995) source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“integrating all of the available evidence indicates that long-term benzodiazepine users may be affected in a generalized rather than specific way, with some areas being more affected than others.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The presence or absence of dementia in older subjects was not typically reported and the possibility of a dementing process as a contributing factor to the cognitive deficits observed cannot be ruled out.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Little is known regarding the potential long-term effects of benzodiazepines.
“Despite such widespread use, little is known regarding the potential long-term effects of benzodiazepines.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“they suggested that longer than 6 months may be needed for recovery from some deficits.”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [170]
The cited source says what the claim attributes to it.
In the citing paper
“For individuals who use BZDs long term, the possible degree of recovery and the extent of residual impairment that may remain after the drugs are withdrawn are unclear (170).”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [170]
The cited source says what the claim attributes to it.
In the citing paper
“A major concern is that loss of memory associated with benzodiazepine use may be lasting, even after treatment discontinuation [62, 63], although other studies reported improved cognitive functioning after discontinuation with increased speed and accuracy of information processing, improved reaction time and working memory [50, 64–66].”
From Mechanisms Underlying Tolerance after Long-Term Benzodiazepine Use: A Future for Subtype-Selective Receptor Modulators? (2012) · cites this paper as [63]
In the citing paper
“In a metaanalysis, Barker et al. (170) concluded that longterm BZD users show recovery of function in visuospatial skills, attention ⁄ concentration, general intelligence, psychomotor speed and nonverbal memory assessments after withdrawal.”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [170]
In the citing paper
“The authors reported that the study data did not demonstrate complete restoration of function within the first 6 months following discontinuation of BZD use”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [170]
In the citing paper
“The authors found, however, that significant cognitive impairment was more persistent in long-term users than in control groups or in normative data.”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [170]
In the citing paper
“compelling evidence not supporting full restitution of cognitive function, at least in the first 6 months after cessation, and suggestion that there may be some permanent deficits in comparison to controls (Barker et al., 2004).”
From A Review of Alprazolam Use, Misuse, and Withdrawal (2018) · cites this paper as Barker et al., 2004
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentr(8) = -0.72reported p < .05 · recomputed p = .019
“r (8) = -.72,p < .05”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
“0.42 unweighted compared to 0.40 weighted, meta-analysis A”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
“| Overall | 44 | 0.42 | 0.41 | 0.22 |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“The mean weighted effect size was -0.48 (median = 0.48) with a standard deviation of 0.45.”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.2. Meta-analysis B: Are previous long-term benzodiazepine users still impaired at follow-up compared to controls or normative data?
Reported 0.48 · recomputed -0.48
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 2.1. Meta-analysis A: Does the cognitive function of long-term benzodiazepine users improve following withdrawal?
“one significant correlation between mean age and attention/concentration, r (8) = -.72,P < .05”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
“The significant negative correlation, between age and overall effect size, suggests that improvement in attention/concentration after withdrawal decreases as age increases.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
“listed in order of decreasing, weighted effect size, meta-analysis A”
§ Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis > 3. Discussion
“| Motor control/performance | 4 | 0.28 | 0.21 | 0.27 | | Verbal memory | 5 | 0.44 | 0.36 | 0.46 |”
Citations
Cites
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,377
A compendium of neuropsychological tests: administration, norms, and commentary
(1991) · Choice Reviews Online · doi:10.5860/choice.29-2400 · Cited by 6,118
(1995) · Cited by 2,809
Cognitive Effects of Long-Term Benzodiazepine Use: A Meta-Analysis
Barker, M. J., Greenwood, K. M., Jackson, M., & Crowe, S. F. (2004) · CNS Drugs · doi:10.2165/00023210-200418010-00004 · Cited by 552
Self-citationChronic use of benzodiazepines and psychomotor and cognitive test performance
Lucki, I., Rickels, K., & Geller, A. (1986) · Psychopharmacology · doi:10.1007/bf00178503 · Cited by 186
Cognitive impairment in long-term benzodiazepine users
Golombok, S., Moodley, P., & Lader, M. (1988) · Psychological Medicine · doi:10.1017/s0033291700007911 · Cited by 167
A cross-national comparison of anti-anxiety/sedative drug use
Baker, M. B., Manheimer, D. I., Mellinger, G. D., & UHLENHUTH, E. H. (1984) · Current Medical Research and Opinion · doi:10.1185/03007998409109541 · Cited by 158
Advances in statistical methods for meta‐analysis
Hedges, L. V. (1984) · New Directions for Program Evaluation · doi:10.1002/ev.1376 · Cited by 142
Cognitive improvement following benzodiazepine discontinuation in elderly nursing home residents
Salzman, C., Fisher, J., Nobel, K., Glassman, R., Wolfson, A., & Kelley, M. (1992) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.930070205 · Cited by 117
Lack of cognitive recovery following withdrawal from long-term benzodiazepine use
Tata, P. R., Rollings, J., Collins, M., Pickering, A., & Jacobson, R. R. (1994) · Psychological Medicine · doi:10.1017/s0033291700026969 · Cited by 97
Research works printed but not linked: 2
- [7]7. * , † Birzele, H. J. (1992). Benzodiazepine induced amnesia after long-term medication and during withdrawal. European Review of Applied Psychology, 42, 277-282.
- [21]21. Lader, M. H. (1982). Psychological effects of buspirone. Journal of Clinical Psychiatry, 43, 62-67.
Cited by
Sorted by citations
European guideline for the diagnosis and treatment of insomnia
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia‐Borreguero, D., Gjerstad, M., Gonçalves, M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12594 · Cited by 2,049
“long-term BZ use, one meta-analysis showed that negative effects might last up to 6 months (Barker et al., 2004).”
Management of Depression in Older Adults: A Review
Kok, R. M., & Reynolds, C. F. (2017) · JAMA · doi:10.1001/jama.2017.5706 · Cited by 890
Sleep, insomnia, and depression
Riemann, D. W., Krone, L. B., Wulff, K., & Nissen, C. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0411-y · Cited by 901
The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023
Riemann, D., Espie, C. A., Altena, E., Arnardottir, E. S., Baglioni, C., Bassetti, C. L. A., Bastien, C., Berzina, N., Bjorvatn, B., Dikeos, D., et al. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14035 · Cited by 834
“…and dependence, nocturnal confusion and falls (Treves et al., 2018), negative effects on cognitive functioning including memory impairment (Barker et al., 2004; Stranks & Crowe, 2014), hangover effects with associated impairments in driving capability, especially from substances with long…”
BackgroundOutcome from mild traumatic brain injury
Iverson, G. L. (2005) · Current Opinion in Psychiatry · doi:10.1097/01.yco.0000165601.29047.ae · Cited by 696
Metadata
- Authors
- Barker, M.
- Affiliations
- La Trobe University (AU)
- Corresponding author
- Barker, M
- Venue
- Archives of Clinical Neuropsychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-04
- Volume
- 19
- Issue
- 3
- Pages
- 437-454
- ISSN
- 0887-6177 (ISSN-L)
- OpenAlex
- W2169064904
- Cited by
- 307
- References
- 34
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 12 · 2023: 13 · 2022: 12 · 2021: 15 · 2020: 21 · 2019: 19 · 2018: 18 · 2017: 25 · 2016: 22 · 2015: 14 · 2014: 12 · 2013: 16 · 2012: 13
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Clinical Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- RMIT Research Repository (RMIT University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- benzodiazepines, long-term benzodiazepine use, benzodiazepine withdrawal, cognitive impairment, cognitive recovery, residual cognitive deficits, benzodiazepine withdrawal syndrome
- MeSH terms
- Benzodiazepines, Clinical Trials as Topic, Cognition Disorders, Humans, Long-Term Care, Neuropsychological Tests, Psychometrics, Substance Withdrawal Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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