For years and sometimes decades, patients have been prescribed drugs to combat anxiety, panic attacks and insomnia but years later, the class of drugs referred to as benzodiazepines (or benzos) has placed many older adults at increased risk for falls and fractures as well as cognitive problems including memory loss. Some studies even link prolonged use of benzos in older age with dementia. Benzo drugs can also cause daytime sedation and lead to motor vehicle accidents.
Despite the known risk of benzodiazepines, a recent study, funded by the National Institutes of Health, found that people between the ages of 65 and 80 were most often prescribed these drugs and many for long-term use.
According to a recent report in the New York Times, seniors are more vulnerable to the side effects of drugs like opioids or benzodiazepines (and even alcohol) because the body metabolized drugs differently in older age. But weaning off the drugs needs to be done carefully, under medical supervision, to avoid dangerous symptoms of withdrawal, even delirium. It can take up to 12 months for an older patient to wean safely off a drug they have become dependent on for years.
Drug with trade names like Valium, Klonopin, Xanax and Ativan can be dangerous for older people but when mixed with opioid pain medications such as Vicodin or OxyContin they can be deadly. Researchers and Geriatricians have been sounding the warning bells for years about co-prescribing benzodiazepines and opioids, especially among adults over the age of 65, and only recently in 2016 did the United States Food and Drug Administration issue a black box warning related to this increasing problem.
It’s important to frequently talk with your doctor or pharmacist about all the medications you are taking and the possibility for dangerous interactions. Members of The Oldish should access the free Medication Checklist under the Toolkit link, fill it out and bring a copy to all appointments with health care providers. Despite the warnings and concern in the medical community, benzo prescriptions continue to rise, even among very elderly patients. And talking about addiction or dependence is often met by older adults with anger so doctors and concerned families or friends may avoid discussing alternative treatments.
Before beginning any plan to taper off benzodiazepine, it’s important to talk in detail with your doctor about how to start weaning off the medication and develop an alternative plan to manage anxiety or insomnia. Relaxation training, supportive therapy and cognitive therapy as well as lifestyle changes that include limiting caffeine and alcohol and improving sleep habits have demonstrated success with older patients.
To learn more about safely tapering benzodiazepines in older adults, follow this link to US Department of Veterans Affairs.