{"id":2896,"date":"2018-10-17T19:08:14","date_gmt":"2018-10-17T17:08:14","guid":{"rendered":"https:\/\/choosingwiselyitaly.org\/raccomandazione-prof\/dont-routinely-prescribe-benzodiazepines-or-z-drugs-in-elderly-patients-in-case-of-insomnia-as-first-choice-treatment-physicians-should-always-recommend-interm\/"},"modified":"2020-05-22T17:02:01","modified_gmt":"2020-05-22T15:02:01","slug":"dont-routinely-prescribe-benzodiazepines-or-z-drugs-in-elderly-patients-in-case-of-insomnia-as-first-choice-treatment-physicians-should-always-recommend-interm","status":"publish","type":"raccomandazione-prof","link":"https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/dont-routinely-prescribe-benzodiazepines-or-z-drugs-in-elderly-patients-in-case-of-insomnia-as-first-choice-treatment-physicians-should-always-recommend-interm\/","title":{"rendered":"Don\u2019t routinely prescribe benzodiazepines or Z -drugs in elderly patients in case of insomnia as first\u00a0choice\u00a0treatment. Physicians\u00a0should\u00a0always\u00a0recommend\u00a0intermittent use of these drugs.In case of chronic use,\u00a0evaluate both the indications and the possible occurrence of side effects"},"content":{"rendered":"<p>Several studies show an increased risk of falls and hip fracture in elderly patients taking benzodiazepines or Z-drugs (zolpidem, zopiclone, zaleplon). This risk also exists for safer protocols (i.e. short-term therapies with low-dose and short half-life drugs). The risk of falls can be increased initially by a reduced state of alertness upon awakening. Later may intervene accumulation with possible motor and cognitive impairments, also favoured by the elderly different pharmacokinetics.<\/p>\n","protected":false},"featured_media":3069,"template":"","meta":{"_edit_lock":["1590159629:2"],"_edit_last":["2"],"_thumbnail_id":["3069"],"_wpml_word_count":["{\"total\":289,\"to_translate\":{\"it\":289}}"],"_yoast_wpseo_primary_eta":[""],"_yoast_wpseo_primary_disciplina":["127"],"_yoast_wpseo_primary_tipologia":[""],"_wpml_media_duplicate":["0"],"_wpml_media_featured":["0"],"_yoast_wpseo_content_score":["90"],"_yoast_wpseo_focuskeywords":["[]"],"_yoast_wpseo_keywordsynonyms":["[\"\"]"],"_wpml_location_migration_done":["1"],"_layouts_template":["layout-for-raccomandazioni-professionista"],"_wp_page_template":["default"],"_wpv_contains_gutenberg_views":[""],"wpcf-pacchetto":["SIMG #1"],"wpcf-bibliografia":["1. Finkle WD et al., Risk of fractures requiring hospitalization after an initial prescription of zolpidem, alprazolam, lorazepam or diazepam in older adults. J Am Geriatr Soc [Internet] 2011 Oct; 59(10): 1883\u20131890.\r\n2. Allain H et al., Postural instability and consequent falls and hip fractures associated with use of hypnotics in the elderly: a comparative review. Drugs Aging [Internet] 2005; 22(9): 749\u2013765.\r\n3. 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 Am Geriatr Soc 2012 Apr; 60(4): 616-31.\r\n4. Bain KT, Management of chronic insomnia in elderly persons. Am J Geriatr Pharmacother. 2006 Jun; 4(2): 168-92.\r\n5. D\u00fcndar Y et al., Newer hypnotic drugs for the short-term management of insomnia: a systematic review and economic evaluation. 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