Confusion and hypnotics in demented patients

Eleven elderly confused patients were given a single dose of chlormethiazole, temazepam and placebo on separate nights with-in a 10-day period. There was no statistically significant difference between the three treatments the next morning in any of the tests, which included subjective and objective measures of mental ability, orientation and hangover effect. These results mirror those previously found in normal, healthy, elderly patients, and do not therefore support the contention that hypnotics increase confusion in demented patients, or that such patients are more sensitive to their actions. Indeed, plasma drug concentrations were on average twice as high in demented as in normal elderly subjects, thus raising the possibility of decreased sensitivity in the demented group. There was little correlation between plasma concentration and pharmacological effect.