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The elderly have less cognitive reserve and are more sensitive to the short (e.g., in between dose withdrawal) and protracted withdrawal effects of benzodiazepines, as well as the side-effects both from short-term and long-term use. This can lead to excessive contact with their doctor.
The prosuicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects or withdrawal symptoms. [11] Because benzodiazepines in general may be associated with increased suicide risk, care should be taken when prescribing, especially to at-risk patients.
Sedation is the side effect people taking lorazepam most frequently report. In a group of around 3,500 people treated for anxiety, the most common side effects complained of from lorazepam were sedation (15.9%), dizziness (6.9%), weakness (4.2%), and unsteadiness (3.4%). Side effects such as sedation and unsteadiness increased with age. [61]
[22] [169] [170] The elderly are more sensitive to the side effects of benzodiazepines, and poisoning may even occur from their long-term use. [171] The various benzodiazepines differ in their toxicity; temazepam appears most toxic in overdose and when used with other drugs.
Lorazepam is preferred to other benzodiazepines and zolpidem due to its longer duration of action. [4] An initial therapeutic effect typically occurs within 10–30 minutes of IV administration lorazepam at doses between 2–4 mg. [5] [4] Higher doses may be used in patients who are unresponsive, to minimise the chance of a false negative ...
The consensus is to reduce dosage gradually over several weeks, e.g. 4 or more weeks for diazepam doses over 30 mg/day, [1] with the rate determined by the person's ability to tolerate symptoms. [120] The recommended reduction rates range from 50% of the initial dose every week or so, [121] to 10–25% of the daily dose every 2 weeks. [120]
But some research has noted rare but serious side effects of once-weekly, 2.4-milligram (mg) semaglutide injections, such as pancreatitis, acute kidney injury, gallbladder issues, and thyroid cancer.
In the elderly a lower dose is recommended due to more pronounced effects and a significant impairment of standing up to 11 hours after dosing of 1 mg of loprazolam. The half-life is much more prolonged in the elderly than in younger patients. A half-life of 19.8 hours has been reported in elderly patients. [4]