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A paradoxical reaction (or paradoxical effect) is an effect of a chemical substance, such as a medical drug, that is opposite to what would usually be expected. An example of a paradoxical reaction is pain caused by a pain relief medication .
Paradoxical reactions are rare in the general population, with an incidence rate below 1% and similar to placebo. [ 8 ] [ 120 ] However, they occur with greater frequency in recreational abusers, individuals with borderline personality disorder , children, and patients on high-dosage regimes.
In the elderly, long-term benzodiazepine therapy is a risk factor for amplifying cognitive decline, [29] although gradual withdrawal is associated with improved cognitive status. [30] A study of alprazolam found that 8 weeks administration of alprazolam resulted in deficits that were detectable after several weeks but not after 3.5 years. [31]
Symptoms may recur and treatment for some days may be necessary. Catatonia due to abrupt or overly rapid withdrawal from benzodiazepines, as part of the benzodiazepine withdrawal syndrome, should also respond to lorazepam treatment. [55] As lorazepam can have paradoxical effects, haloperidol is sometimes given at the same time. [54] [56]
Paradoxical disinhibition is a paradoxical reaction, an uncommon but recognized phenomenon, characterized by acute excitement and an altered mental state, caused by benzodiazepines. The mechanism is poorly known, but the most accepted theory is that it occurs secondary to inhibition of the restraining influences of the cortex and frontal lobe ...
Improved reaction times were noted at 52 weeks in elderly patients free from benzodiazepines. This is an important function in the elderly, especially if they drive a car due to the increased risk of road traffic accidents in benzodiazepine users. [136] At the 24-week follow-up, 80% of people had successfully withdrawn from benzodiazepines.
New RSV vaccines are now available to help prevent serious infection in people over 60. Doctors explain the RSV vaccine and its side effects in older adults.
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]