Use of benzodiazepines in the elderly may increase the risk of cognitive and psychomotor impairment, falls, fractures, hospital admissions, delirium, and motor vehicle accidents. These risks may be higher in the elderly due to decreases in drug metabolism and slower elimination of these drugs, particularly long-acting benzodiazepines. Use of these drugs may also lead to dependence, abuse, and withdrawal symptoms. Use of benzodiazepines should be avoided in this population, and should not be used as first-line treatment for insomnia, agitation, or delirium.
Benzos are listed in the Beers Criteria of inappropriate medications for older adults.
- Benzodiazepine Receptor Agonist deprescribing guideline (published in Canadian Family Physician).
- Benzodiazepine Receptor Agonist deprescribing algorithm. Bruyere Research Institute at deprescribing.org.
- Whiteboard video on using the Benzodiazepine Receptor Agonist deprescribing algorithm Bruyere Research Institute at deprescribing.org.
- Patient handout on Benzodiazepine receptor agonists. Bruyere Research Institute at deprescribing.org.
- A guide to deprescribing benzodiazepines. Primary Health Tasmania.
- Choosing Wisely Canada.
- Madhusoodanan & Bogunovic (2004) Safety of benzodiazepines in the geriatric population
- FDA label for lorazepam.