Prolonged persistent anterograde amnesia due to chronic self-prescribed midazolam therapy for insomnia.

This article presents a case report focusing on prolonged persistent anterograde amnesia resulting from chronic self-prescribed midazolam therapy for insomnia in a 30-year-old male without prior psychiatric history. The patient self-administered midazolam 7.5 mg three times weekly over six months, initially improving sleep but subsequently developing significant short-term and anterograde memory impairments that persisted after drug discontinuation. Comprehensive evaluations excluded structural brain abnormalities and major psychiatric disorders, supporting benzodiazepine-related cognitive dysfunction as the cause. Treatment with trazodone improved sleep quality but yielded minimal cognitive recovery, and the patient declined cognitive behavioral therapy for insomnia (CBT-I). The report underscores the neurocognitive risks of unsupervised, prolonged benzodiazepine use and highlights the importance of patient education, therapeutic oversight, and prioritization of evidence-based insomnia treatments to prevent long-term cognitive sequelae.