However, elderly patients are more likely to have confusion and severe drowsiness, or age-related heart, liver, or kidney problems, which may require caution and an adjustment in the dose for patients receiving clonazepam .
Probably the most serious: falls and fractures, already a common danger for older people , because benzos can cause dizziness. They’re also associated with auto accidents, given that they cause drowsiness and fatigue. Moreover, “they have a negative effect on memory and other cognitive function,” says Dr.
Long-term use of benzodiazepines like Klonopin has been linked to an increased likelihood of developing Alzheimer’s disease later in life. CBS News reports the increased risk is as high as 51 percent.
Short-half-life benzodiazepines, such as oxazepam , alprazolam , and triazolam , are usually recommended for older adults, because these agents do not accumulate in the blood, are rapidly cleared from circulation, and offer greater dosage flexibility.
Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines , another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.
Choice of antidepressant The selective serotonin reuptake inhibitors (SSRIs) and the newer antidepressants buproprion , mirtazapine, moclobemide, and venlafaxine (a selective norepinephrine reuptake inhibitor or SNRI) are all relatively safe in the elderly.
In the elderly, nonbenzodiazepines such as zolpidem , eszopiclone , zaleplon , and ramelteon are safer and better tolerated than tricyclic antidepressants, antihistamines, and benzodiazepines . Pharmacotherapy should be recommended only after sleep hygiene is addressed, however.
liver problems. severe liver disease. sleep apnea. susceptible to breathing fluid into lungs.
However, elderly patients are more likely to have unwanted effects (eg, severe drowsiness or unsteadiness) and age-related kidney or liver problems, which may require caution and an adjustment in the dose.
Clonazepam may be taken every day at regular times or on an as needed (“PRN”) basis. Typically, your healthcare provider will limit the number of doses you should take in one day . Your healthcare provider will determine the dose and method of taking the medication that is right for you based upon your response.
Clonazepam can be successfully discontinued without any major withdrawal symptoms if the dose is reduced gradually. We recommend reducing the dosage of clonazepam after intermediate-term use by 0.25 mg/wk.
Hepatotoxicity. Clonazepam , as with other benzodiazepines, is rarely associated with serum ALT elevations, and clinically apparent liver injury from clonazepam is extremely rare. However, at least one convincing case report of acute liver injury from clonazepam with recurrence on reexposure has been reported.
Antidepressants. Antidepressants for the treatment of adults with generalized anxiety disorder include the selective serotonin reuptake inhibitors (SSRIs) escitalopram (Lexapro) and paroxetine (Paxil), and the serotonin-norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and venlafaxine (Effexor).
Nonetheless, in recent decades they have largely replaced barbiturates because they tend to be safer if taken in large doses. Another anti-anxiety drug is busprirone (Buspar). It has fewer side effects than the benzodiazepines and is not associated with dependence.
Sertraline is generally well tolerated in elderly patients with major depressive disorder and lacks the marked anticholinergic effects that characterise the adverse event profiles of tricyclic antidepressants (TCAs).