Aging Begins at 30

Effective Medications Can be Misused

You probably don't recognize benzodiazepines but the trademarked names Valium and Librium are household words. These man-made compounds have a ring of six carbons (the benzo part) joined to a 7-member ring with 5 carbons and 2 nitrogens indicated by diazo. They were put together in 1960 in the laboratories of Hoffman LaRoche in Basel, Switzerland. Many variants of the original drugs have been made, but they all have much the same effect. Those excreted quickly are more suitable for the elderly. Valium is now prescribed more often than any other oral drug in the U.S.

A third of the users of these drugs is 55 or older. The medicines are indicated for anxiety, insomnia, convulsions, and muscle relaxation. In a recent review, over a third of patients had used their benzodiazepine for more than six years.

The benzodiazepines are psychotropic which means turning to the mind and so they have mind-altering effects. The good effects are the control of anxiety and insomnia. Bad effects occur when a person is on them (somnolence, dizziness, poor memory, depression, pseudodementia, etc.) and when the person is taken off them and is experiencing withdrawal symptoms (anxiety, tension, tremors, enhanced smell, taste and touch sensations, feelings of unreality, and seizures). Alcohol might worsen the first aspect, but might alleviate the latter. Worst of all benzodiazepines can cause memory related problems and impair learning, most often in the elderly. Temporary memory does not get transferred to long-term memory storage. Many elderly women (the drug is used more often in them) are substantially more mentally alert after discontinuing the drugs when pseudo-aging disappears.

Patients in a confused state from over use, have a significantly increased risk of falling and having a hip fracture. Diminished alertness from these drugs in elderly patients may be confused with senility or dementia. Used as sleeping pills, some effects may continue during the next day with diminished alertness and hand-eye coordination and impair the ability to drive an automobile.

Ninety percent of eight month or longer users experience withdrawal symptoms if taken off the drugs suddenly, as noted in the bad effects above, and this may last as long as six weeks. Benzodiazepines are good medicines for four months, but not usually for longer. Tolerance (a greater dose to produce the original effects) and dependency may occur with drowsiness, muscle incoordination, slurred speech, and dizziness. When discontinued, they must be withdrawn gradually.

These very effective drugs can be useful but they can also be too much of a good thing. Maybe grandma's "senility" can be cured.

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