GRAY MATTERS: Sleeping and anxiety pills carry health risks people a pamphlet and make them aware of the potential long-term complications And it found that Ambien use resulted in one in five ER visits among the 65.
Like many providers, Leer has been leery of prescribing sedative-hypnotics.
So I said, okay. Gave him a low dose and reminded him of the risks of unsteadiness and falling when getting up.”. “But they wouldn’t have it. Sleep patterns change with age, he said. They really, really wanted Ambien.
The brochure notes that is no longer recommended to take a sedative-hypnotic drug to treat insomnia or anxiety and that people who take such drugs have five times the risk of memory and concentration problems, four times the risk of daytime fatigue, twice the risk of falls and fractures of the hip and wrist and twice the risk of having a motor vehicle accident while driving.
Carol Harrison is a writer of “Gray Matters” articles for the Area 1 Agency on Aging.
Recent studies have linked sedative-hypnotic drugs to significantly increased risk of falls, fractures and Alzheimer’s disease.
“I’ll still prescribe sedative-hypnotic drugs, but not before I hand people a pamphlet and make them aware of the potential long-term complications,” said Leer, a physician at Eureka Family Practice with an interest in gerontology.
“Even if you think that you have no side effects, and even if you take only a small dose, a sedative hypnotic drug worsens your brain performance and slows your reflexes,” the brochure states.
At six months, 27 percent of those in Tannenbaum’s study group had discontinued benzodiazepine use compared to 5 percent of the control group.
Canadian and French researchers linked benzodiazepine use to a 51 percent increase in the risk of developing Alzheimer’s disease, and the risk increases with ongoing exposure. A well-respected and carefully designed study accepted August 2014 by BMJ (formerly the British Medical Journal) raises other concerns.
“But I do it because people want them and historically, physicians have always felt safe prescribing them. They’ve been marketed by pharma as a mild tranquilizer that is safe when taken for long periods of time.”.
“That’s a difference in the realm of a quarter of patients revising their medications after reading the brochure, which is very impressive in terms of changing behaviors,” Love said.
The article mentioned the success Dr. A July 30, 2014, article by Paula Span in the New York Times prompted Leer and Martin Love, chief executive officer of the IPA, to take action. Cara Tannenbaum had in weaning patients off sedative-hypnotics through a pamphlet and its tapering-off program.
The IPA printed 200 copies for its members. The pamphlet is also available online at http://tinyurl.com/IPApamphlet.
People don’t want to part with their sleeping pills and anxiety medications, but Dr. Lee Leer and the Humboldt-Del Norte IPA think older adults may be wise to reconsider.
“I had an elderly patient come in with his family. The biggest complaint was he couldn’t sleep the way he would in the past, but that’s not surprising,” Leer said.
By Carol Harrison, For the Times-Standard.
In 2013, the American Geriatric Society put sedative-hypnotics on its Choosing Wisely list of “Five Things Physicians and Patients Should Question.”
“He slipped, fell and broke his hip in the first week. “He was essentially drunk,” Leer said. There’s no question in my mind that Ambien was the culprit.”.
And it found that Ambien use resulted in one in five ER visits among the 65 and older group, more than any other medication.
Posted: 02/16/15, 12:51 PM PST| Updated: on 02/16/2015.
Researchers reported no association for less than 91 daily doses, but risk increased 32 percent for 91-180 cumulative daily doses and 84 percent for more than 180 doses.
“Although the long-term effectiveness of benzodiazapines remains unproved for insomnia and questionable for anxiety, their use is predominantly chronic in older people,” the study authors noted. “Unwarranted long-term use of these drugs should be considered as a public health concern.”.
Today's high Today's low.
“What I would emphasize to people who have been taking one of these drugs for 10 or 15 years and have never had a problem is that you have never been 65 or 70 and taking these drugs,” Leer said. “The effect will be different, and it won’t be obvious until they get up and stumble.”.
Last summer, the CDC and Johns Hopkins University reported a high number of emergency room visits associated with psychiatric medications in general and Ambien in particular. It looked at visits by age and drug and found the consequences were worse for older people visiting the ER. About a third of those visitors age 65 and older were hospitalized — three times the hospitalization rate for ages 19-44.
It didn’t go well when the man had to go to the bathroom in the middle of the night.