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Given Lorazenpam As Sleep Aid, Seems Agitated, Change In Behavior. Is This Good Medicine At 78 Yrs Age ?
My 78 yr old mother was given lorazenpam 1. mg for a sleep aid in Nov. 2012 she has recently been upped to 2 mg and I am uncomfortable with her change in behavior. She is a very small women who hasn't drank or taken many medications her whole life. She now has slurred speech and her reaction time is much slower, she seems agitated and her she acts like she has just gotten up from a deep sleep. From what I have read this is often a drug used for only short periods of time and after 8 months her doses is being doubled. I have also read that this isn't a best choice for a sleep aid for a senior. What are your thoughts and what would be your recommendation in this situation?
I have a call into her Dr. at this point.
I have a call into her Dr. at this point.
Mon, 8 Jul 2013
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Hi,
Benzodiazepines like lorazepam are prescribed with caution in elderly patients because of the risk of excess drowsiness, falls, dependence, tolerance etc. The agitation you see in your mother maybe because of a side effect of this drug seen in elderly known as 'paradoxical disinhibition' where you see irritability, restlessness and agitation etc. These drugs are best avoided in elderly.
Drugs that are useful and safe are non-benzodiazepines like zolpidem, zaleplon etc and melatonin agonists like ramelteon.
Do not stop the drug abruptly, it can cause withdrawal symptoms, it needs to be tapered down slowly over many weeks considering the fact she has already taken it for 8 months.
Also the cause of her insomnia has to confirmed, whether it is caused because of some drugs that she is taking chronically for any physical illness like hypertension etc or, insomnia due to other mental illnesses like depressive disorder etc. Or if it is simply age related.
Consult a psychiatrist.
Hope this helps,
Dr A Rao
Benzodiazepines like lorazepam are prescribed with caution in elderly patients because of the risk of excess drowsiness, falls, dependence, tolerance etc. The agitation you see in your mother maybe because of a side effect of this drug seen in elderly known as 'paradoxical disinhibition' where you see irritability, restlessness and agitation etc. These drugs are best avoided in elderly.
Drugs that are useful and safe are non-benzodiazepines like zolpidem, zaleplon etc and melatonin agonists like ramelteon.
Do not stop the drug abruptly, it can cause withdrawal symptoms, it needs to be tapered down slowly over many weeks considering the fact she has already taken it for 8 months.
Also the cause of her insomnia has to confirmed, whether it is caused because of some drugs that she is taking chronically for any physical illness like hypertension etc or, insomnia due to other mental illnesses like depressive disorder etc. Or if it is simply age related.
Consult a psychiatrist.
Hope this helps,
Dr A Rao
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