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    Benzodiazepine Safety

    Often prescribed. Often dangerous in seniors.

    Common benzos

    • Xanax (alprazolam).
    • Ativan (lorazepam).
    • Valium (diazepam).
    • Klonopin (clonazepam).
    • Restoril (temazepam).
    • Used for anxiety + insomnia.

    Why dangerous in seniors

    • Falls — 50%+ increased risk.
    • Hip fractures.
    • Confusion + delirium.
    • Memory problems.
    • Increased dementia risk (controversial but possible).
    • Highly addictive.
    • Withdrawal dangerous.
    • BEERS Criteria — avoid in seniors.

    Safer alternatives

    • Anxiety — SSRIs (sertraline, citalopram). Slower onset, safer long-term.
    • Sleep — sleep hygiene, melatonin, trazodone.
    • CBT-I — cognitive therapy for insomnia. Free app from VA.
    • Buspar (buspirone) — safer for daily anxiety.
    • Therapy — long-term solution.

    If on benzo long-term

    • NEVER stop suddenly — withdrawal seizures.
    • Doctor must taper slowly (months).
    • Some require year+ taper.
    • Switch to longer-acting first sometimes.
    • Many seniors successfully discontinue.
    • Quality of life improves after.

    Tell your doctor

    • Get pharmacist medication review.
    • Ask about Beers Criteria for your meds.
    • Consider taper if on benzo long-term.
    • Get geriatric specialist if multiple meds.
    • Mediation reconciliation yearly.
    • You have right to discuss alternatives.

    Z-drugs same risks

    Ambien (zolpidem), Lunesta, Sonata = same fall + confusion risks. Also avoid in seniors per Beers Criteria. Sleep hygiene + CBT-I = better long-term. Many seniors over-prescribed sleep + anxiety meds. Review.