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Benzodiazepines

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Abstract

Benzodiazepines are used for a variety of indications. Age-related changes in the pharmacokinetics and pharmacodynamics of benzodiazepines place older people at increased risk for side effects. Decreased hepatic blood flow, albumin level, lean body mass, and an increased elimination half-life of active metabolites all play a role. These drugs can result in excessive sedation, cognitive impairment, delirium, agitation, and balance problems leading to falls and fractures. Consistent adverse effects related to benzodiazepine use have been reported in the community, in nursing homes, and in hospitals. Guidelines for rational use of benzodiazepines in older individuals should be followed. If needed, short-term treatment (i.e. less than 4 weeks for insomnia) might be considered using an intermediate-acting benzodiazepine. Patients should be clearly informed of the risk of falls when using these drugs. Long-term prescribing should be avoided. Benzodiazepine withdrawal strategies should be proposed to chronic users with proper psychological support and a drug tapering schedule adjusted to the patient’s individual needs.

Keywords

  • Sleep Quality
  • Lean Body Mass
  • Hepatic Blood Flow
  • Central Nervous System Disorder
  • Dysthymic Disorder

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Abbreviations

BZD:

Benzodiazepine

CI:

Confidence interval

CNS:

Central nervous system

FRID:

Fall risk-increasing drug

GABA:

Gamma-aminobutyric acid

HR:

Hazard ratio

OR:

Odds ratio

Z-drug:

Zolpidem, zopiclone, eszopiclone, zaleplon

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Correspondence to Annemie Somers PharmD, PhD .

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Somers, A., Petrovic, M. (2016). Benzodiazepines. In: Huang, A., Mallet, L. (eds) Medication-Related Falls in Older People. Adis, Cham. https://doi.org/10.1007/978-3-319-32304-6_10

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  • DOI: https://doi.org/10.1007/978-3-319-32304-6_10

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  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-32302-2

  • Online ISBN: 978-3-319-32304-6

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