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Ativan and Dementia

Sedatives like Ativan/Lorazepam (benzodiazepine class) are prescribed to one in eight Americans. Women and elders are three times more likely to be given a long-term prescription, which is not recommended.

We know that Ativan’s side effects in the elders are worse than for younger people.

Ativan Side Effects in Elderly

The problem is… it works at first. Ativan use in the elders can make them look calm; they are really drugged, like giving them a shot of vodka. It is addictive like alcohol and people become tolerant and the calming (sedating) effect wears off and the dose often needs to be increased.

This may work for a while, but it is not worth it– not for the side effects of Ativan, especially if a dose is missed. It can cause confusion, aggression, poor sleep, and even sometimes delirium. It can lead to drowsiness and falls, and if the elder is not moving around much, pressure ulcers, blood clots, and aspiration pneumonia. Really.

Ativan Dementia Agitation

Just look up Ativan Dementia Agitation; it causes all sorts of problems. For those with Alzheimer’s disease, Lewy Body disease, alcoholic dementia, frontal dementia, and vascular dementia, it exacerbates mood swings, confusion and of course, the addiction and withdrawal symptoms.

Elders end up much worse, with behavior, function, and medical complications than if they had not started the Ativan.

Ativan Dementia Agitation

Alternatives to Ativan in Elderly

1) Keeping elders busy during the day in a dementia day program, or bringing the seniors to church, family gatherings, walks, gardening, as long as they do not get overstimulated or overtired. Keeping engaged with life is the first best step.

2) Treat pain. Motrin/Naprosyn used long term will increase risks of heart attacks, strokes, dementia, renal damage, heart failure and high blood pressure. A better idea, for most elders, is a long-acting Tylenol tablet (lasts 8 hours) twice a day (always check with your doctor- those with liver disease may be at risk). Physical therapy and keeping people moving will also help with pain, check with your doctor and physical therapist.

3) Sleep. Avoiding most sleeping pills is a good idea. Over the counter such as Tylenol PM, or Unisom will make elders more confused. Keeping them awake with only a 30- 60 minute nap during the day is a great start. Then also keep them physically active. Like everyone else, they will sleep better if they exercise.

Lorazepam Side Effects Elderly

Lorazepam Side Effects in Elderly

Sue had been using Ativan/Lorazepam occasionally when she was anxious or could not sleep. She started to get more sleepy during the day (a Lorazepam hangover) and so her doctor gave her a nightly dose. She became more irritable in the afternoon and so the doc had her take the dose twice a day. Then she started to forget exactly how much of her medications she had taken and at times would take double the dose… or none at all. On the days she took none, she would get angry, paranoid and accuse the neighbors of taking her mail (that was on the table). She would call the police with similar reports. If she took too much she would be more confused and fall more often. Her daughter finally had enough.

Lorazepam Side Effects in Elderly with Dementia

So does Sue have dementia? Well, possibly. However, it is not possible to tell when an elder is taking these sedatives (Ativan/Lorazepam is a common benzodiazapine) or is withdrawing from these meds. The best way to know is to slowly, with a geriatrician’s help, taper the Ativan and have an evaluation when the elder is off the medications that affect thinking. The risks of these meds are falls, accidents, fractures and head injuries, confusion, paranoia, poor sleep and it is all worse with sudden withdrawal. They can become combative and delirious.

It is important to have a geriatrician address the medical situation and medications. Removing the wrong medications before adding more is the first step to healing.

In California, call now for a TeleHeath visit.  Elsewhere, join our DLG Community to learn more and share your experience.

It may seem hopeless to improve outcomes for elders with serious behaviors…. But it is not. The first step is to get more information and support on the steps to get rid of the wrong medications for your elder and find the medications that will help. Join our Community.