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Benzodiazepine hypnotics in the elderly.

P J Cook

    Acta Psychiatrica Scandinavica. Supplementum
    |January 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Elderly individuals show a 2-3 fold greater response to benzodiazepines due to post-receptor changes, not altered drug levels. Lower doses are recommended for frail elderly patients to prevent sedation and psychomotor impairment.

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    Area of Science:

    • Pharmacology
    • Gerontology
    • Neuroscience

    Background:

    • Benzodiazepines are commonly prescribed medications.
    • Ageing affects drug pharmacodynamics.
    • Disease can also alter drug responses.

    Purpose of the Study:

    • To review changes in benzodiazepine pharmacodynamics during ageing and disease.
    • To investigate the mechanisms behind increased sensitivity in the elderly.

    Main Methods:

    • Review of controlled studies involving single doses of diazepam, temazepam, nitrazepam, and flunitrazepam in different age groups.
    • Animal studies examining cerebral drug concentrations and receptor binding.
    • Analysis of regular dosing effects and clinical trials.

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    Main Results:

    • Elderly subjects exhibit a 2-3 fold greater response to benzodiazepines compared to younger individuals.
    • Increased response in the elderly is attributed to post-receptor mechanism alterations.
    • Regular dosing leads to accumulation and increased sedation in the elderly, especially those with dementia or renal failure.
    • Low doses of nitrazepam (2.5 mg) or temazepam (10 mg) are suggested for frail elderly patients.

    Conclusions:

    • Ageing significantly enhances benzodiazepine effects through post-receptor modifications.
    • Careful dose selection is crucial for elderly patients to mitigate risks of sedation and cognitive impairment.
    • Further research into age-related changes in GABAergic neurotransmission is warranted.