Potential Untoward Effects of Long-Term Use of Flurazepam in Geriatric Patients

Marttila, James K.; Hammel, RJ; Alexander, Bruce; Zustiak, Robert

doi:10.1016/s0003-0465(16)33229-3

Cited by 15 publications

(10 citation statements)

References 10 publications

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“…Studies comparing neuroleptics and benzodiazepines suggest that neuroleptics are more likely to be effective. Sedation, confusion, memory impairment, and ataxia are commonly reported side effects in older patients taking benzodiazepines, 70–78 and these side effects are likely to be more common in the older demented patient. Although not reported specifically in the elderly, paradoxical rage reactions and disinhibition have been reported with diazepam and chlordiazepoxide 79 .…”

Section: Benzodiazepinesmentioning

confidence: 99%

Pharmacologic Treatment of Agitation Associated With Dementia

Risse

Barnes

1986

J American Geriatrics Society

120

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Pharmacotherapy of aggressive or agitated behaviors in the dementia patient has not been studied extensively, despite the prevalence of this problem. Neuroleptics have the most support for efficacy, with shorter acting benzodiazepines demonstrating benefit on occasion. However, studies done to date indicate that these drugs are effective only for a minority of patients and that side effects frequently make patients worse. Other medications, such as propranolol, carbamazepine, or lithium, may be helpful, but their efficacy in dementia patients has not been demonstrated in placebo-controlled studies. Until such studies are done, their use is most appropriate in special patient groups or in patients who have failed neuroleptic or benzodiazepine treatment. More studies are needed in elderly patients evaluating effectiveness of pharmacologic agents in specific types of dementia, particularly Alzheimer's disease. Most studies done to date have been of relatively short duration, usually two months or less. Because these medications often are given to dementia patients for prolonged periods, studies are needed to define the long-term clinical efficacy of these agents. In the clinical setting, these agents should be reduced periodically or discontinued to determine ongoing need. In addition, environmental, social, or behavioral methods of reducing agitated behaviors need to be explored as an adjunct to any medication trial.

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Section: Benzodiazepinesmentioning

confidence: 99%

Pharmacologic Treatment of Agitation Associated With Dementia

Risse

Barnes

1986

J American Geriatrics Society

120

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“…For example, the study of Derbez and Grauer 67 mentions that all patients who were considered for their study had sometime in the past received hypnotics every night. Marttila et al 176 stated that 26 per cent of 750 patients in “intermediate care facilities” were medicated routinely with flurazepam, which suggests that the overall percentage was much higher. A USPHS survey of physicians' prescribing patterns in skilled nursing facilities showed that prescriptions for sedative‐hypnotics were written for 94.2 per cent of the 98,505 patients studied 264 .…”

Section: Sedative‐hypnotics For Treating Insomnia In the Agedmentioning

confidence: 99%

“White Paper” on Sleep and Aging

Dement¹,

Miles²,

Carskadon³

1982

J American Geriatrics Society

227

122

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“…In ad dition to issues o f hypnotic efficacy, the tox icity profile o f a given hypnotic is different in the elderly compared to young adults. For example, chloral hydrate, which enjoys a reputation for minimal side effects, may pro duce confusion and hallucinations in a large percentage o f nursing home patients [Kra mer, 1967], Flurazepam produced severe problems such as ataxia, confusion and hallu cinations in 26% of nursing home patients over 60 years old [Manila et al" 1977], Such findings imply that the general body of knowledge about the safety o f sedatives/hypnotics, largely derived from studies o f youn ger adults, does not necessarily apply to the elderly.…”

Section: H Sleeping Pills In the Elderlymentioning

confidence: 99%

Rational Basis for the Use of Sleeping Pills

Dement¹

1983

Pharmacology

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The diagnosis and treatment of insomnia is a major clinical issue. This is because the complaint of insomnia is highly prevalent and because the various clinical and laboratory manifestations of insomnia are complex. In addition, insomnia involves both day and night. This paper attempts to provide a rational framework for the evaluation of insomnia and the use of sleeping pills. Insomnia is defined and described with special attention to differentiating the subjective complaint and the laboratory assessment of objective sleep parameters. Specific disorders causing or associated with sleep disturbance and the complaint of insomnia are described, and some data bearing on relative prevalence of specific disorders are presented. Consideration of sleeping pills involves the evaluation of hypnotic efficacy as a property of the medication on the one hand and the practical clinical application on the other. Properties of different hypnotics are reviewed, including factors that affect the use of hypnotics in clinical practice. It is concluded that the rational use of sleeping pills demands a systematic approach to the evaluation of the individual patient and a specific attempt to formulate individual treatment goals together with a knowledgeable consideration of the specific chemotherapeutic agent to be utilized.

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Potential Untoward Effects of Long-Term Use of Flurazepam in Geriatric Patients

Cited by 15 publications

References 10 publications

Pharmacologic Treatment of Agitation Associated With Dementia

Pharmacologic Treatment of Agitation Associated With Dementia

“White Paper” on Sleep and Aging

Rational Basis for the Use of Sleeping Pills

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