![]() Tobacco and alcohol are the most common substances that elderly individuals develop dependence on or misuse. Research has found that withdrawing elderly people from benzodiazepines leads to a significant reduction in doctor visits per year, it is presumed, due to an elimination of drug side-effects and withdrawal effects. This can lead to excessive contact with their doctor. 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. Failure to treat benzodiazepine dependence in the elderly can cause serious medical complications. Long-term use and benzodiazepine dependence is a serious problem in the elderly. See also: Benzodiazepine withdrawal syndrome § Elderly Withdrawal symptoms include anxiety, perceptual disturbances, distortion of all the senses, dysphoria, and, in rare cases, psychosis and epileptic seizures. īenzodiazepine dependence is a frequent complication for those prescribed for or using for longer than four weeks, with physical dependence and withdrawal symptoms being the most common problem, but also occasionally drug-seeking behavior. The Department of Health substance misuse guidelines recommend monitoring for mood disorder in those dependent on or withdrawing from benzodiazepines. Benzodiazepine dependence and withdrawal have been associated with suicide and self-harming behaviors, especially in young people. Some withdrawal symptoms that may appear include anxiety, depressed mood, depersonalisation, derealisation, sleep disturbance, hypersensitivity to touch and pain, tremor, shakiness, muscular aches, pains, twitches, and headache. The signs and symptoms of benzodiazepine dependence include feeling unable to cope without the drug, unsuccessfulĪttempts to cut down or stop benzodiazepine use, tolerance to the effects of benzodiazepines, and withdrawal symptoms when not taking the drug. See also: Benzodiazepine withdrawal syndrome § Signs and symptoms This is in part due to the greater effectiveness over time of other forms of therapy, and also due to the eventual development of pharmacological benzodiazepine tolerance. ![]() With longer-term use, other therapies, both pharmacological and psychotherapeutic, become more effective. In the short term, benzodiazepines can be effective drugs for acute anxiety or insomnia. ![]() Numbers of benzodiazepine prescriptions have been declining, due primarily to concerns of dependence. Long-term benzodiazepine treatment may remain necessary in certain clinical conditions. Some authors, however, disagree and feel that benzodiazepines retain their anxiolytic properties. Tolerance develops within days or weeks to the anticonvulsant, hypnotic, muscle relaxant and after 4 months there is little evidence that benzodiazepines retain their anxiolytic properties. ![]() Smaller groups include patients escalating their dosage to higher levels and drug misusers as well. These individuals typically do not escalate their doses to high levels and generally use their medication as intended by their prescriber. Therapeutic dose dependence is the largest category of people dependent on benzodiazepines. When benzodiazepines are stopped, these neuroadaptations are "unmasked" leading to hyper-excitability of the nervous system and the appearance of withdrawal symptoms. The increased GABA inhibition on the neural systems caused by benzodiazepines is counteracted by the body's development of tolerance to the drug's effects the development of tolerance occurs as a result of neuroadaptations, which result in decreased GABA activity and increased excitability of the glutamate system these adaptations occur as a result of the body trying to overcome the central nervous system depressant effects of the drug to restore homeostasis. ![]() It is necessary to distinguish between addiction to and abuse of benzodiazepines and physical dependence on them. Īddiction consists of people misusing or craving the drug not to relieve withdrawal symptoms, but to experience its euphoric or intoxicating effects. Benzodiazepine dependence develops with long-term use, even at low therapeutic doses, without the described dependence behavior. In the case of benzodiazepine dependence, however, the continued use seems to be associated with the avoidance of unpleasant withdrawal reaction rather than from the pleasurable effects of the drug. Medical condition Benzodiazepine dependenceīenzodiazepine dependence defines a situation in which one has developed one or more of either tolerance, withdrawal symptoms, drug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV. ![]()
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