Good for the elderly
The anti-anxiety medications oxyazepam and lorazepam are frequently prescribed to patients who are at risk of drug buildup, such as the elderly and those suffering from liver disease, since they are metabolized differently from other benzodiazepines, namely by conjugation.
Long-term benzodiazepine use among the elderly (persons aged 65 years or older), who represent for 12.5% of the overall population, is increasing. This problem deserves consideration due to the predicted growth in this section of the population, as well as the fact that older people are more susceptible to severe reactions to benzodiazepines. This is the case in this col-
A wide range of drugs are recommended for older people, and many of these medications are psychotropic in nature (1).Benzodiazepines are the most often prescribed sedative-hypnotic medications accessible today.They are also the most widely used (2).According to a research conducted by Morgan and colleagues (3), the prevalence of usage of hypnotic medications (with benzodiazepines accounting for 92% of all hypnotic drug use) among per-
Patients above the age of 65 are more likely to respond to therapy for benzodiazepine dependence. However, there are little resources available for tackling this issue among the older population, as previously stated.
Geriatrics in the Real World (12). In patients who are benzodiazepine-dependent and who utilize benzodiazepines rather than a pro-sedative, adverse medication responses may be experienced to a larger extent.
Benzodiazepines with a short half-life, such as oxazepam, alprazolam, and triazolam, are often advised for older persons because they do not build in the bloodstream, are promptly removed from circulation, and allow for more dosing flexibility.
Buspirone is an anti-anxiety medication that has been demonstrated to be beneficial in the treatment of elderly patients. However, because they have the potential to induce memory impairment, unsteadiness, and falls in older persons, benzodiazepines, another anti-anxiety medication, should only be taken with caution.
Benzodiazepines and similar pharmaceuticals, which are among the most regularly prescribed medications, are commonly used to treat anxiety, sleeplessness, muscular spasms, and epilepsy in the elderly, despite the well-known hazards associated with using these medications in this population.
It has been shown that the use of benzodiazepines in older persons can impair cognition, mobility, and driving abilities, and can increase the risk of falling. A previous study also discovered a link between benzodiazepine usage in elderly adults and an increased risk of Alzheimer’s disease, according to the researchers.
Persons over the age of 65 are at the greatest risk of experiencing harmful effects from benzodiazepine medications such as Ativan (lorazepam) or Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), Librium (chlordiazepoxide), and Tranxene (tranxene chlordiazepoxide) (clorazepate dipotassium).
In contrast, older patients are more prone to have disorientation and extreme sleepiness, as well as age-related heart, liver, and renal issues. As a result, patients using clonazepam should exercise caution and increase their dose accordingly, if necessary.
A large number of conventional benzodiazepines are degraded in the liver, and when they are taken with medications that inhibit this breakdown, blood levels might rise, resulting in negative effects. Because they have less liver enzyme interactions, lorazepam, oxazepam, and temazepam are less prone to cause this problem.
As defined by the updated Beers Criteria published by the American Geriatrics Society in 2015, paroxetine is a powerful anticholinergic that is regarded possibly unsuitable for older individuals with dementia and cognitive impairment.
Anxiety medications such as Remeron (mirtazapine) and Xanax (alprazolam) are prescribed. Aside from treating depression and nausea, Remeron is also used to treat posttraumatic stress disorder and as an appetite stimulant. Xanax is also used to treat panic attacks in some cases.
Benzodiazepines are a family of medications that can be used to treat a wide variety of medical problems. They are often prescribed by doctors to treat anxiety, seizures, and sleeplessness. The short-term use of these drugs is normally safe and effective, but the long-term use of these medications can result in tolerance, dependency, and other negative consequences.
In contrast, elderly patients are more likely to experience unwanted side effects (such as severe drowsiness, dizziness, confusion, clumsiness, or unsteadiness) and organ dysfunction (such as kidney or liver failure), which may necessitate caution and a dose reduction for patients taking this medication.
When dealing with chronic anxiety, long-acting benzodiazepines such as diazepam and clorazepate are often recommended, but episodic anxiety is usually better treated with shorter-acting benzodiazepines such as oxazepam or lorazepam, respectively.
Age-related renal, liver, and cardiac issues in senior individuals are more common than in younger people, and they may necessitate greater vigilance and dose reductions in order to avoid undesired side effects (such as severe sleepiness or unsteadiness).
Because of the potential for cumulative toxicity, long-acting benzodiazepines are generally not recommended for elderly individuals. High-potency chemicals (e.g., lorazepam, alprazolam) may be more harmful than low-potency compounds when it comes to short-half-life medications (e.g., benzodiazepines) (e.g., oxazepam).
It is possible that older persons are more sensitive to these impacts. Additionally, some older persons may not find Ativan to be effective in relieving their anxiety. Instead, it can create anxiety and disorientation, as well as an increase in the risk of falling, which is the primary cause of accidents among persons over the age of sixty-five.