Persons over the age of 65 are at the greatest risk for adverse effects from benzodiazepine drugs like Ativan (lorazepam) or Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), Librium (chlordiazepoxide) and Tranxene (clorazepate dipotassium). Despite heightened risks, this age group remains the second highest prescribed group of benzodiazepines, with 8.9% of the elderly population prescribed them and 31% of these prescriptions considered long term.
Given the availability of options that are far less harmful, benzodiazepines should rarely be considered a first option when it comes to treating people over the age of 65. It is, at minimum, important for prescribers to provide informed consent, explaining these risks to the patients (or their caregivers) if they are not able to make the decision on their own.
Inappropriate Treatment for the Elderly
The Screening Tool of Older Person’s Prescriptions (STOPP) and Beers Criteria for Potentially Inappropriate Medication Use in Older Adults classify benzodiazepines as inappropriate treatment for the elderly. Beers warns that older adults have increased sensitivity to benzodiazepines and decreased metabolism of long-acting agents. They also warn that they may increase the risk of cognitive impairment, delirium, falls, and motor vehicle crashes in older adults.