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Pregabalin, sold under the brand name Lyrica among others, is an anticonvulsant, analgesic, and anxiolytic amino acid medication used to treat epilepsy, neuropathic pain, fibromyalgia, restless legs syndrome, opioid withdrawal, and generalized anxiety disorder (GAD).
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 [136] At the 24-week follow-up, 80% of people had successfully withdrawn from benzodiazepines.
The prosuicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects or withdrawal symptoms. [11] Because benzodiazepines in general may be associated with increased suicide risk, care should be taken when prescribing, especially to at-risk patients.
[6] [12] Existing evidence on the use of gabapentinoids in chronic lower back pain is limited, and demonstrates significant risk of adverse effects, without any demonstrated benefit. [13] The main side-effects include: a feeling of sleepiness and tiredness, decreased blood pressure, nausea, vomiting and also glaucomatous visual hallucinations. [14]
Long-term use is controversial due to adverse psychological and cognitive effects, decreasing effectiveness, dependence, and benzodiazepine withdrawal syndrome, following withdrawal after long-term use. The elderly are at an increased risk of experiencing both short- and long-term adverse effects.
Elderly people are also at a heightened risk for developing TD, [10] as are females and those with organic brain injuries or diabetes mellitus and those with the negative symptoms of schizophrenia. [25] TD is also more common in those that experience acute neurological side effects from antipsychotic drug treatment. [25]
In recent years, gabapentin has seen increased use, particularly in the elderly. [25] There is concern regarding gabapentin's off-label use due to the lack of strong scientific evidence for its efficacy in multiple conditions, its proven side effects and its potential for misuse and physical/psychological dependency. [26] [27] [28]
In the elderly, nitrazepam is associated with an increased risk of falls and hip fractures due to impairments of body balance. [35] The elimination half-life of nitrazepam is 40 hours in the elderly and 29 hours in younger adults. [36] [37] Nitrazepam is commonly taken in overdose by drug abusers or suicidal individuals, sometimes leading to death.