Helpful Meds Can Become Harmful As You Grow Older (Op-Ed)
Bob Rosenblatt is a researcher, writer and journalist who writes about the intersection of finances and aging. This article first appeared on the site HelpWithAging.com. Rosenblatt contributed this article to Live Science's Expert Voices: Op-Ed & Insights.
A drug that helped you cope with depression in your 30s, 40s, and 50s can become a menace to your health when you enter your 60s and beyond. Too many patients and too many of the doctors who first wrote the prescriptions may not realize something that was a great help in coping with anxiety and depression threatens to do great harm at a different stage in life. A body's ability to process and manage medicines becomes less effective as we age.
The category of drugs to watch out for is called benzodiazepines. Medicare Part D is covering these medications for the first time in 2013, and this calls for alertness by both patients and doctors. The following drugs are the benzodiazepines, with generic name first, then brand name in parentheses:
- Alprazolam (Xanax)
- Chlordiazepoxide (Librium)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Estazolam (ProSom)
- Flurazepam (Dalmane)
- Lorazepam (Ativan)
- Midazolam
- Oxazepam (Serax)
- Temazepam (Restoril)
- Triazolam (Halcion)
- Quazepam (Doral)
They are often prescribed for anxiety, agitation, muscle spasms and sleep disorders. Here is the warning from the American Geriatrics Society (AGS), the specialty group for treating the health of older persons, about the dangers of these drugs for patients aged 65 and older: "Older adults have increased sensitivity to benzodiazepines and slower metabolism of long-acting agents. In general, all benzodiazepines increase risk of cognitive impairment, delirium, falls, fractures and motor vehicle accidents in older adults."
When you get to be 65 and beyond, these drugs can make you dizzy and precipitate falls, which are a great danger for older people.
"Falls can be devastating," warns the U.S. Centers for Disease Control and Prevention (CDC)."About one-out-of-ten falls among older adults result in a serious injury, such as a hip fracture or head injury, that requires hospitalization. In addition to the physical and emotional pain, many people need to spend at least a year recovering in a long-term care facility."
And falls can be deadly, the CDC says. "Falls are the leading cause of injury deaths among older adults. The rate of fall-related deaths among older adults in the United States has risen significantly over the past decade. In 2004, falls were responsible for 14,900 deaths."
It's not just the benzos that pose a potential risk to older people. The process of aging makes the body less efficient at absorbing, metabolizing and eliminating all sorts of drugs. Older adults may get many prescriptions from many different doctors, and the drug interactions may cause serious problems.
The AGS publishes a summary list of those drugs that may be inappropriate for older patients, including possible side effects and dangers. The advice to doctors is to be extremely cautious in using any of those medications for their older patients.
"This should be viewed as a guide for identifying medications for which the risks of use in older adults outweigh the benefits," the AGS says. "These criteria are not meant to be applied in a punitive manner. This list is not meant to supersede clinical judgment or an individual patient's values and needs. Prescribing and managing disease conditions should be individualized and involve shared decision-making."
The AGS is saying that the final decision on which drugs to use and when to use them is the business of an individual patient and his or her doctor, but the advice from the experts is to be cautious.
Many older people take multiple prescriptions, and it's not just the anti-anxiety drugs that can pose a threat. Any medications can give you problems if they interact badly with other things you are taking.
So once a year, schedule a "brown bag" day with your primary care doctor. Fill a bag with the bottles of all the pills you take — the ones prescribed by the doctor, as well as any you bought over-the-counter — plus the vitamins and the special pills you bought from the health food store, and the magic roots your brother-in-law gave you after his South American odyssey. Have the doctor review everything and then decide what you should keep taking and what to avoid.
And if you want to do a little investigation on your own, try this drug checker, while the AGS provides general advice about over-medication.
And finally, pharmacies are busy places these days. To make sure you got the right pill at the store use this pill identifier to check the size, color and shape of the medication.
This article first appeared as "12 Anti-Anxiety Drugs That Become Dangerous When You Get Older" on the site HelpWithAging.com. The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on Live Science.
