Xanax
Xanax, Alprazolam, is in the category of sedatives prescribed to one in eight Americans.
“Xanax is the Crack of the Suburbs”
OK, I said that. Xanax is shorter acting and twice as powerful as Ativan… so it is more addictive.
Xanax Side Effects in Elderly
Xanax side effects in elderly are worse as well. Elders can withdrawal before their next dose! Which will lead to agitation, which leads to an higher dose, which leads to more withdrawal….
Side effects of Xanax in elderly include confusion, sedation, falls, poor sleep, and withdrawal is even worse if a dose or several are missed; aggression, and delirium.
Xanax for Sleep in the Elderly
Xanax for sleep in the elderly is thought by some medical personnel to be fine, but it is not. Like an alcoholic nightcap, it will help with sleep, at first, then lead to waking sooner and with more agitation.
Xanax vs Ativan in elderly is a clear choice. Well, actually, we don’t use either, but Xanax is twice as powerful and shorter acting than Ativan. Ativan lasts longer and is easier to taper slowly. It still should only be tapered by a small amount only every few weeks.
Dementia and Xanax
Dementia and Xanax is more complicated. People with Alzheimer’s or vascular dementia, Lewy Body dementia, alcoholic dementia, vascular dementia, frontal dementia (also frontotemporal dementia) are often given Xanax when they have difficult behaviors. It may help calm the elder for a short time, but being more addictive, short acting and powerful, it will lead to irritability and agitation that escalates if they miss a dose, or even between doses.
Xanax for Dementia Agitation
Xanax for dementia agitation always makes things worse. Since it is short acting, it may work for a few weeks, months, but it is addictive and the calming (sedating) wears off and the agitation will be worse than before the medication.
Long term Xanax use in and dementia is tough, but treatable. Always have your physician’s supervision to make any medication changes. Xanax should alway be doubled and changed to Ativan- then the total dose should be divided into 3 daily doses. Stop any other sedating meds if the elder is sedated during the day. Then slowly over months taper the dose a little bit every few weeks. There will be aggression, but the dose should be held at that level until the behavior has stabilized, before making more changes.
Avoid caffeine and alcohol (taper off this as well). Avoid most over the counter sleeping pills (melatonin works for some, but can cause daytime sleepiness or confusion.
Again, always keep elders engaged in activities they enjoy.
Keep them physically busy, walking is a terrific way to burn off restlessness and help sleep.