Sensitivity to Triazolam in the Elderly

Correlates and prevalence of benzodiazepine use in community-dwelling elderly

“…Thus, elderly participants on long-acting benzodiazepines may be noticing adverse effects including daytime sedation, ataxia, and slowed psychomotor performance and selftitrating their dose downward. 9,[18][19][20][21] The high rate of PRN prescribing for benzodiazepine may suggest that physicians view the disorder for which the drug was prescribed as an intermittent problem. Among hypnotic benzodiazepines, another potential explanation for the high rate of PRN prescribing is the recommendation that when benzodiazepines are used to treat insomnia they should be taken no more often than 2 to 4 times a week to avoid dependence.…”

“…[1][2][3][4][5][6] However, in the elderly, the safety of benzodiazepines is less clear because of their impaired metabolic elimination and increased sensitivity. [7][8][9][10][11][12][13][14] An estimated 10.9 million (6.2%) of U.S. adults purchased or obtained benzodiazepines in 1987, and of those aged 65 years and older (elderly), 11.3% to 13.7% reported taking a benzodiazepine in the previous year. 15,16 In 1988, individuals over 60 constituted approximately 20% of the U.S. population, yet received 49% of all prescriptions for benzodiazepines.…”

“…17 Benzodiazepines are associated with a number of adverse effects including daytime sedation, ataxia, and slowed psychomotor performance. 9,[18][19][20][21][22] One of the more severe adverse effects of benzodiazepine use in the elderly is an increased risk of hip fracture. [23][24][25][26][27][28] Concomitant use of benzodiazepines and other agents such as over-the-counter (OTC) sleep aid medication or alcohol may potentiate the adverse effects of benzodiazepines by increasing the risk of adverse outcomes.…”

Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life

“…Most studies that have involved people over 65 years-of-age have looked at effects of a single dose of BZD and therefore have limited clinical relevance. These have found either similar or greater levels of impairment that persist significantly longer in older compared to younger people (Pomara et al 1985(Pomara et al , 1998Hinrichs & Ghoneim, 1987;Nikaido et al 1990 ;Greenblatt et al 1991). Residual effects on daytime performance following single or several night-time doses have also been documented in older people (Morgan, 1994).…”

“…Older adults are more susceptible to the effects of BZDs and other psychotropics because agerelated changes in pharmacokinetic processes (particularly distribution, metabolism and clearance) can greatly prolong the effects of these drugs (Greenblatt et al 1991). Older people often take a combination of drugs, including centrally-acting ones, which can compound side-effects.…”