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[citation needed] For example, the equivalent dose of diazepam in an elderly individual on lorazepam may be half of what would be expected in a younger individual. [7] [8] Equivalent doses of benzodiazepines differ as much as 20 fold. [9] [10] [11]
A similar lorazepam dose given intravenously will result in an earlier and higher peak serum level, with a higher relative proportion of unmetabolised (active) lorazepam. [106] On regular administration, maximum serum levels are attained after three days. Longer-term use, up to six months, does not result in further accumulation. [98]
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.
However, at 2 mg doses, there were significant increases in stage 3 sleep and reductions in REM sleep. Rebound effects have been reported after chronic use including rebound REM. [ 4 ] In one clinical trial with patients who had prior experience with older hypnotics temazepam and nitrazepam , most preferred lormetazepam due to less heavy ...
[2] [6] A study in Northern Ireland, looking at prescribing in 1965, reported that the BNF was likely able to serve the requirements of prescribers in general practice, while also achieving a cost saving. [7] By 2003, issue 46 of the BNF contained 3000 interactions or groups of interactions, with about 900 of these marked by a bullet. [8] [9 ...
Tolerance and dependence are risks of chronic benzodiazepine use, and can result in doses within the therapeutic range ceasing to offer meaningful symptomatic relief after prolonged use. Tolerance develops at different rates and to different degrees to the sedative, hypnotic, anticonvulsant, muscle relaxant and anxiolytic effects of benzodiazpines.
Delorazepams potency is approximately equal to that of lorazepam, being ten times more potent by weight than diazepam (1 mg delorazepam = 1 mg lorazepam = 5 mg diazepam), [21] typical doses range from 0.5 mg - 2 mg. Treatment is generally initiated at 1 mg for healthy adults and 0.5 mg in pediatric and geriatric patients and patients with mild ...
In the elderly a lower dose is recommended due to more pronounced effects and a significant impairment of standing up to 11 hours after dosing of 1 mg of loprazolam. The half-life is much more prolonged in the elderly than in younger patients. A half-life of 19.8 hours has been reported in elderly patients. [4]