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In the elderly, long-term benzodiazepine therapy is a risk factor for amplifying cognitive decline, [29] although gradual withdrawal is associated with improved cognitive status. [30] A study of alprazolam found that 8 weeks administration of alprazolam resulted in deficits that were detectable after several weeks but not after 3.5 years. [31]
Compared with the benzodiazepines including flurazepam, the nonbenzodiazepine sedative-hypnotics appeared to offer few, if any, significant clinical advantages in efficacy in elderly persons. Tolerability in elderly patients, however, is improved marginally in that benzodiazepines have moderately higher risks of falls, memory problems, and ...
Failure to treat benzodiazepine dependence in the elderly can cause serious medical complications. [14] The elderly have less cognitive reserve and are more sensitive to the short (e.g., in between dose withdrawal) and protracted withdrawal effects of benzodiazepines, as well as the side-effects both from short-term and long-term use. This can ...
Nordazepam is a partial agonist at the GABA A receptor, which makes it less potent than other benzodiazepines, particularly in its amnesic and muscle-relaxing effects. [6] Its elimination half life is between 36 and 200 hours, with wide variation among individuals; factors such as age and sex are known to impact it. [2]
Chlordiazepoxide is generally considered an inappropriate benzodiazepine for the elderly due to its long elimination half-life and the risks of accumulation. [10] Benzodiazepines require special precaution if used in the elderly, pregnancy, children, alcohol- or drug-dependent individuals and individuals with comorbid psychiatric disorders. [11]
Improved reaction times were noted at 52 weeks in elderly patients free from benzodiazepines. This is an important function in the elderly, especially if they drive a car due to the increased risk of road traffic accidents in benzodiazepine users. [136] At the 24-week follow-up, 80% of people had successfully withdrawn from benzodiazepines.
Additionally the elderly are more sensitive to the adverse effects of benzodiazepines compared to younger individuals even when blood plasma levels are the same. Use of benzodiazepines in the elderly is only recommended for 2 weeks and it is also recommended that half of the usual daily dose is prescribed. [7]
Prazepam is a benzodiazepine derivative drug developed by Warner-Lambert in the 1960s. [2] It possesses anxiolytic , anticonvulsant , sedative and skeletal muscle relaxant properties. [ 3 ] Prazepam is a prodrug for desmethyldiazepam which is responsible for the therapeutic effects of prazepam.