The Use of Benzodiazepines in the Elderly Population: Epidemiology, Risks and Withdrawal Management

Benzodiazepines remain one of the most commonly prescribed medications. Approximately 9% of adults in the United States aged 65 years or above are benzodiazepine users. The use of benzodiazepines is associated with several adverse outcomes, including dependence, cognitive deficits, falls and fractures, and overall mortality. Therefore, their use raises a significant concern for public health. Measures should be taken to reduce the use of benzodiazepines, especially in the geriatric population. A key method of benzodiazepine withdrawal management is tapering – a slow reduction of doses, sometimes combined with other interventions such as switching to long-acting benzodiazepines or adding adjunctive medications. Furthermore, psychological interventions, including cognitive behavioral therapy, can be applied. Additionally, alternative therapeutic options, including treatment with flumazenil, propranolol, captodiamine and others, are being studied. All clinicians, especially those in primary care, should prescribe benzodiazepines with great caution, always bearing in mind that they are not recommended in the geriatric population; safer alternatives to benzodiazepines should be suggested. They should also remain alert for benzodiazepine dependence in elderly individuals. Keywords: benzodiazepines, elderly, substance withdrawal syndrome, substance abuse, primary health care, geriatrics