Dr. Chris Aiken discusses the risks of anti-anxiety medication in older adults, emphasizing the importance of tapering off to reduce adverse effects. Topics include dangers of deprescribing, risks of abrupt discontinuation, navigating anti-psychotic meds in dementia patients, and guidance on tapering and substituting anxiety medications for the elderly.
Deprescribing benzodiazepines in older adults reduces fall risks and improves stability.
Tapering off various medication classes in older adults requires careful strategies to prevent withdrawal symptoms.
Deep dives
Deprescribing Anxiety Medications in Older Adults
Tapering anti-anxiety medications in older adults, such as benzos, is crucial due to the increased risks of falls, sedation, and accidents associated with these medications in older age. The podcast highlights a case of an older adult on lorazepam who experienced a fall and initially denied any link to the medication, emphasizing the common denial among patients regarding the risks. It stresses the importance of carefully tapering off benzodiazepines to mitigate withdrawal symptoms and improve patient outcomes, illustrated by a case where discontinuing lorazepam led to improved stability and reduced symptoms for an elderly patient.
Deprescribing Other Classes of Medications
The podcast discusses deprescribing other classes of medications beyond benzodiazepines, including z-hypnotics, antidepressants, antihistamines, anti-convulsants, and anti-psychotics, in older adults. It points out the risks associated with each class, such as falls, cognitive impairment, and drug interactions, emphasizing the need for careful tapering strategies to avoid discontinuation syndromes. Specific tips are provided for tapering these medications, highlighting the importance of individualized approaches and close monitoring to ensure a safe and effective transition.
Safer Alternatives and Management Strategies
In addressing anxiety in older adults, the podcast explores safer alternatives to anxiety medications, such as psychotherapy, pregabalin, gabapentin, buspirone, and mirtazapine. It underscores the importance of considering tolerability and side effects when selecting alternative medications, providing dosing recommendations for each option in older adults. Additionally, the podcast mentions the use of Melatonin and Orixin antagonists as safer options for sleep in conjunction with managing anxiety in the elderly population, highlighting the significance of choosing appropriate medications based on individual patient needs and risks.
Chris Aiken, MD, and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
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