Benzodiazepines like Xanax, Valium and Klonopin can have different affects on those who are older than younger people. Sometimes older people are prescribed these medications, but are not supervised for the proper use. Learn about them and how to prevent side effects from taking benzodiazepines.
Other websites to further explore this subject. Check out my website at Kathysconsulting.com or send me an email at info@kathysconsulting.com
https://jamanetwork.com/journals/jama/article-abstract/417260 mva
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703317/
https://journals.lww.com/psychopharmacology/Abstract/2002/06000/Long_Term_Benzodiazepine_Use_and_Cognitive_Decline.9.aspx cognitive decline
https://pubmed.ncbi.nlm.nih.gov/25208536/
https://pubmed.ncbi.nlm.nih.gov/26256008/
Welcome to knowledge for caregivers. My name is Kathy, the host of this podcast. Since I have been a geriatric nurse for almost 10 years helping seniors age in place. I'm going to give you the knowledge that I use to help my own family so you can help your family
Welcome to this podcast about benzodiazepines. I am glad that now in our society It is easy and comfortable to talk about mental health. Often it can be a difficult subject because people are embarrassed about it. I have struggled with anxiety for the past 10 years. I started out taking some of your basic anxiety medicines, which are called selective serotonin reuptake inhibitors, or SSRIs. These are medications like Zoloft, Cymbalta or Prozac. These medications help your brain retain more of those feel good hormones. They worked very well for me. My anxiety was manageable, and the good thing I could sleep at night. Unfortunately, several years ago, I began to develop severe headaches from the SSRIs. That means I had to stop taking them. I started to go see a counselor to see if that would help me with my anxiety. I was managing pretty well but I was still having trouble sleeping. When I went to my regular doctor, he put me on a medicine called Clonazepam. Clonazepam belongs to a group of medicines called benzodiazepines. Benzodiazepines is a hard word to say. Throughout this podcast, I will just refer to them as benzos. Besides Clonazepam are also valium and Xanax. And there are some other lesser known ones.
Back to Clonazepam. I was finally sleeping. But I found that I could not go to sleep without taking some of them every night. Finally, I went on some blood pressure pills for my anxiety, and was able to come off the Clonazepam except for my occasional breakthrough anxiety, but then the pandemic of 2020 hit. As a nurse, it was incredibly stressful. I was back to needing the Clonazepam every night. When I talked to my psychiatrists about this, he said, Well, we need to figure out a way to get you off of those because benzos have shown to cause dementia problems, especially if you are older. As a nurse, I was surprised that I was not aware that Benzo's can lead to dementia. A lot of my clients are on Benzo's. This became a topic that I wanted to research so that I would be able to educate them. The dangers with benzos is that they have what we call a long half life. Half Life means how long it takes half of the medicine to leave your body. On top of having a long half life, it is even longer in older people. This happens for several reasons. Older people have more fat distributed about their body, the benzos will get stored in the fat and last longer in their body. Older people's liver and kidneys don't work as well. These are the major two organs that will filter out medication from someone's body. Older people also have special receptors in their brain that seemed to make them more sensitive to Benzo's. As I said, many of my clients are prescribed benzos.
One lady I will never forget, I went to her home, she was on Xanax. She literally had these little plastic cups that we put juice in at parties, five or six of them all scattered throughout their house filled with Xanax. I sat down to try to educate her about how dangerous this was because she didn't know how many that she was taking. She became very upset at me, and I could tell that she had developed a dependence on Xanax. The half life for Xanax is about six to 12 hours. The half life for valium is 20 to 100 hours. Imagine if you're an older person, and you take Xanax either once or twice a day. You may not have even filtered out all the old medicine before you take some new ones. Those levels of benzos can build up in an older person's body and can cause them to be sedated. Benzos can also be very addicting. The first time that I was described benzos was actually before the Clonazepam 10 years ago. My doctor hooked me on Zoloft and Xanax. Xanax worked very well. It took care of all my anxiety and I slept great. When I went to the psychiatrist he said get rid of your Xanax. I have a Lady that is very addicted and I have to literally wean her off crumb by crumb and it's still very hard. That scared me. I never took Xanax again after that.
Also, if you have a loved one do not depend on the physician to pick up that they may become dependent on Benzo's. Doctors are not usually looking for medication dependence for those who are not showing obvious signs. Therefore, it is a condition that can be often overlooked. This is especially true for women. Women have a tendency to become more addicted to Benzo's as men will tend to become addicted to alcohol, and benzos. Alcohol addiction is easier to pick up it will show signs like liver problems, they can smell it on people's breaths. Benozs are prescribed because as people get older, they began to deal with a unique set of problems. This causes them a lot of anxiety. Older people worry about becoming a burden to their family and becoming disabled. They worry about how they're going to take care of themselves. If they don't have family when their health is failing, they began to have sleep problems. Studies have shown that if you can correct that sleep problem quickly, it may not last long term but benzos are an easy medication to prescribe, because they do work very well with those who have sleep problems. If someone takes a benzo for less than 90 days, it is highly unlikely that they will become dependent on it. They also do not hardly ever experience any long term side effects. On the other hand, studies are coming out showing that long term benzo use leads to the risk of dementia and cognitive decline in older people.
They have also found that their risk of dependence on benzo increases with age due to the many reasons I stated before. Studies have also found that many individuals in nursing homes or assisted livings are prescribed benzos. The United States government has come out with guidelines that benzos and other highly psychiatric medicines can only be described if the doctor assesses the client and determines that they have an actual psychiatric condition. Yet when they go in to do surveys of these facilities, they find that many times they do not have a diagnosis. People in these assisted livings can many times feel isolated and depressed. That is a big reason they are prescribed benzos It is very difficult sometimes to treat an older people with depression.
Doctors have a hard time knowing is this depression. Is this dementia? Is it just a normal sign of aging? We have to be attuned to our loved ones and bring up if we think that they are depressed. Depression is something that always needs to be assessed by a primary care doctor. The reason is, there can be some other causes for depression that are not a mental health reason. For instance, a lack of vitamin B can cause depression, it is best if someone is depressed, to find the best medication that will help them and also be willing to look at counseling. There are many safe medications for older people to deal with depression and anxiety besides Benzo's. In that study, where they found that a lot of nursing home residents and assisted living residents were prescribed benzos, they also found that they were under treating their depression with safer medications.
One of the things as our parents get older, they may be just 65 or 70 and still in great health. They're active, they're leading their own lives. They're not about to let their kids come in and ask him what's going on. This is how I would approach parents how I approach my own parents. I say something like mom, I know you're healthy. But I've heard that sometimes you can fall, go to the hospital. It's very important for me to know your medical history, what medicines you're on what tests you've had done. That way, if you do end up in the hospital, I know what is going on with you. That will give you an idea of what medication Your parents are on. If they are on benzos. You could say wow, how long have you been taking this because I've heard that there's some side effects to Xanax. Remember, if they say they've been taking it several years, you can't just run in there and yank it away because they will have withdrawals. It is a medicine that people can become dependent on. They have to be weaned off of it very slowly.
A lot of times if you just educate people that this can affect your memory, they're more willing to come off of it because people fear losing their mind, almost more than anything else. The one time that benzos are extremely appropriate to use is when someone is on hospice, when they're on hospice, basically. The doctor has said they have about six months left to live. Depending on what condition they have, many of them can become anxious and scared. And it is very common to prescribe benzos. During that time, if they're in a facility, make sure that benzos are not the first medication prescribed, but is a last result. Unfortunately, sometimes people say, oh, they're overusing benzos. And they go too far to the other side and say you can never use benzos we don't want to take away all the tools in our toolbox to treat somebody who might need benzos after everything else has been tried. One of the other reasons that it's good to know if your family is on benzos is they have found that with older adults, it slows down their motor skills. Many older adults who are recently prescribed benzos but are still driving, they will have an increased chance of having a car wreck. They will have an increased chance of having a fall they will have an increased chance of breaking something. That's when they're first prescribed benzos if you have an 80 year old loved one, they've never taken benzos, then they're not sleeping at night in their prescribed bins as it's important to know that my dad's 89 years old, he still builds houses and drives, I'm definitely would not want him to be taking a benzo working on power tools, people that have fallen and broken a bone. Many times when they look back, they were recently prescribed benzos if your loved one is in a facility is on benzos make sure that they have a plan of how they're going to prevent the falls. But the studies are now beginning to show that besides the falling in the car wreck, those who take benzos for long term, especially if they're older, it appears that more of them began to experience some form of dementia benzos have their place.
The medical community is beginning to see their research and cutting back on prescribing benzos especially to older people, even though we don't want to prescribe benzos to older people, if possible. We still want to treat their mental health problems. Medications is always a good line. We often think oh older people didn't grow up in the era where we talked about mental health, but many of them will be more open to it than we actually realize. In the United States. here in Oklahoma. We have several outpatient clinics that cater to older people. They will also provide them transportation if they no longer can drive. I'm sure in many other countries that have good health care, mental health services can be provided to the elderly. Again, I know this has been a little longer than my other episodes. Thank you for listening. Try to keep track to find out if your loved one is on Benz's why they're on it, and if it appears that they are dependent or overusing it. If it is possible attempt to see if you can get them weaned off of it. Sometimes you can't. But at least you will know what to monitor them for with their driving or their possibility of falling so that you can take the intervention necessary.
All information is meant for informational purposes only and is not meant to replace medical advice. Thank you for listening to this podcast knowledge for caregivers. You can check out my website, Kathy's consulting.com or send me any questions at my email info at Cathy's consulting.com Do not forget to leave me a review of this podcast or give suggestions for other ships. Thank you to all the dedicated caregivers out there.