Elderly Health

Benzodiazepines are sleep-inducing and anti-anxiety drugs with a potential for physical and psychological dependence. Abrupt discontinuation or rapid tapering of chronic treatment can lead to withdrawal symptoms, some of which may be life-threatening. The main side effects of benzodiazepines include drowsiness, impaired memory and concentration, and instability (1)(2). Numerous studies have shown that the use of benzodiazepines or Z-drugs in the elderly increases the risk of accidents, falls, and fractures (3)(4). Despite the concerning evidence regarding the potential harm of inappropriate or chronic use of these medications, such use remains common in developed countries, particularly among the elderly population.

From a pharmacokinetic perspective, benzodiazepine preparations differ in their duration of action: Short-acting agents begin to work quickly and have relatively brief effects, while long-acting agents produce more prolonged effects. Older adults are particularly sensitive to the side effects of benzodiazepines, both due to increased sensitivity of the nervous system and the slower breakdown of long-acting benzodiazepines. Age-related slowed metabolism leads to higher blood levels of benzodiazepines and accumulation of the drug in the body. For this reason, the use of long-acting benzodiazepines is not recommended at all in the elderly (5)(6).