Document Detail

Benzodiazepines: tolerability in elderly patients.
MedLine Citation:
PMID:  8843497     Owner:  NLM     Status:  MEDLINE    
Aging is a physiological process that shares many behavioral, biochemical and neuroendocrine phenomena with the pathophysiological situation of unresolved stress, as well as with a pharmacologically induced syndrome resulting from chronic benzodiazepine (BZ) consumption. Behavioral findings include symptoms such as drowsiness, ataxia, fatigue, confusion, weakness, dizziness, vertigo, syncope, reversible dementia, depression, impairment of intellectual, psychomotor and sexual function, agitation, auditory and visual hallucinations, paranoid ideation, panic, delirium, depersonalization, sleepwalking, aggressivity, orthostatic hypotension, and insomnia. Neuroendocrine findings include: central depletion of noradrenaline (NA), dopamine, adrenaline (AD), and serotonin (5-HT); reduction in the ratio of circulating NA/AD as well as platelet 5-HT and increase of AD, plasma free 5-HT and cortisol. These disturbances together with the increased platelet aggregability observed in the three groups are typical of unresolved-stress situations. Immunological findings include significant reduction of peripheral T lymphocytes (CD3, CD4, CD8) and the CD4/CD8 ratio, CD16 and gamma-delta cells. On the other hand, the three groups (elderly subjects, subjects faced with unresolved stress, and BZ consumers) show increase of the CD57 lymphocyte subset as well as natural killer cytotoxicity. Alterations of several biological markers have also been found, specifically in the oral glucose tolerance test, the intramuscular clonidine test, and the supine/orthostasis/exercise test. From a clinical point of view, the three groups appear to be more susceptible to the appearance and progression of many acute and chronic diseases (infectious and malignant diseases). As a result, chronic consumption of BZs should be avoided in both the elderly and subjects in unresolved-stress situations.
F Lechin; B van der Dijs; M Benaim
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Psychotherapy and psychosomatics     Volume:  65     ISSN:  0033-3190     ISO Abbreviation:  Psychother Psychosom     Publication Date:  1996  
Date Detail:
Created Date:  1997-01-21     Completed Date:  1997-01-21     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0024046     Medline TA:  Psychother Psychosom     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  171-82     Citation Subset:  IM    
Section of Psychopharmacology, Central University of Venezuela, Caracas.
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MeSH Terms
Aging / physiology*
Benzodiazepines / adverse effects*,  contraindications*
Biological Markers
Central Nervous System / physiopathology
Cognition Disorders / etiology
Hypotension / etiology
Immune System Diseases / etiology
Mental Disorders / etiology
Neurosecretory Systems / physiopathology
Neurotransmitter Agents / physiology
Sleep Disorders / etiology
Stress, Psychological / physiopathology*
Reg. No./Substance:
0/Biological Markers; 0/Neurotransmitter Agents; 12794-10-4/Benzodiazepines

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