Don’t use benzodiazepines in elderly patients as a first choice for insomnia, agitation, delirium.

Type of practice


Elderly people assuming hypnotics (mainly benzodiazepines) experience car accidents and falls with femur fractures and consequent hospitalization, more often than others. Also the hospitalized patients assuming benzodiazepins risk falls and their consequences, due to depressed alertness, motor deficits and cognitive impairment. The use of these drugs should be limited to alcohol withdrawal and anxious states. When requested, low dosage, short half-life and intermittent use should be preferred, and prolonged use should be submitted to frequent re-evaluation. In case of agitation and delirirum, other drug should be preferred.


1. Couto AT, Silva DT, Silvestre CC, Lyra DPJr. Quality analysis of research on the use of benzodiazepins by elderly patients in the emergency room: a systematic review. Eur J Clin Pharmacol 2013: 60; 1343-50. doi: 10.1007/s00228-012-1439-7.
2. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society Updated Beers Criteria for potentially inappropriate medication use in older adults. J Amer Geriatr Soc 2012; 60: 616-31.
3. Finkle WD, Der JS, Greenland S, al. Risk of fractures requiring hospitalization after an initial prescription of zolpidem, alprazolam, lorazepam or diazepam in older adults. J Am Geriatr Soc 2011; 59: 1883-90.
4. Allain H, Bentue-Ferre D, Polard E, Akwa Y, Patat A. Postural instability and consequent fall and hip fractures associated with use of hypnotics in the elderly: a comparative review. Drugs Aging 2005; 22: 749-65.

Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.