Interdisciplinary approach to discontinuing benzodiazepines -- for elderly

Hi All,

This article shows how an interdisciplinary team of healthcare professionals can help elderly people in a geriatric day hospital to safely discontinue their benzodiazepine medication. It's very positive and shows the beneficial effects of a team approach. Excellent work!

 

http://www.rxfiles.ca/rxfiles/uploads/documents/ltc/HCPs/Insomnia/Benzo.pdf

I didn't read that much of the article, but I was noticing that the tapering was extremely fast. I couldn't imagine taking such huge cuts with either Ativan or Klonopin. I'm amazed that they didn't note any people having excruciating w/d symptoms. Maybe I didn't look closely enough. Or maybe all of these people were the lucky ones.

 

It's one thing to successfully taper a person off a drug, but what is just as important, if not more so, are the months following the end of tapering. I think doctors are pretty much entirely clueless about this extremely valuable fact, and to me the failure to recognize this as being of heightened importance is at the crux of the whole matter.

 

I'm afraid this article makes it seem too easy to get off benzos.

 

 

My other question would be that if some of these elderly people were going through bad w/d after tapering, what other drugs were they given to counter the effects of w/d? The elderly seem to be the most drugged of the population and the least likely to withstand the onslaught of drugs, so that to me is a worry. I realize this article was just concerning the taper, but since extremely quick tapering methods were used, it leaves me wondering what the aftermath was.

 

 

Thanks for sharing! I like the importance they place on support throughout this article. One thing I noticed, and maybe I'm just missing something, is they listed a 79-year-old female who had taken 5 mg of diazepam for 30 years and her tapering schedule said, "NA - Stopped abruptly." Yikes 

Hi Everyone,

I had another quick look at the article and had a few thoughts. One, I'm extremely happy to see a team approach to benzodiazepine withdrawal, and yes, courteney, I agree that support is such a key factor. And two, on a negative note, I wonder if they're telling us everything. Is it possible that there were so few symptoms? Was there a larger sample that we're not hearing about? Are these the lucky folks who don't get a bad withdrawal, while those of us here on BB are the unlucky ones?

 

The third point -- a positive one --  is that it's possible to get off these meds at any age and that there can be benefits, i.e. it's never too late.

 

Anyway, I was really happy to see an article -- a Canadian one -- that shows an awareness that benzodiazepine withdrawal can be difficult and that a team approach can be helpful. Also, it's important that pharmacists are part of the team and may even be the ones to bring the topic up with unsuspecting patients. I've wondered about the role of the pharmacist in all of this, e.g. repeat prescriptions of benzodiazepines dispensed despite literature stating that they're meant for short-term use.

 

Suffice to say, I have questions.

 

It's great to hear other people's input, so thanks for weighing in!