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Avoid Ativan, Xanax; Klonopin may help

Posted by 3 Beer Effect on January 31, 2002, at 21:28:33

In reply to Best Benzo for Anxiety in Elderly?, posted by fachad on January 30, 2002, at 12:17:44

>He could put her on a regular dosing of Klonopin (once or twice per day, every day). It has serotogenic effects that would eliminate her worrying better than Xanax could. Also, unlike Xanax or Ativan it is also a fairly subtle medication in that it takes 1 or 2 hours to start working, has a 12 hour duration, and a half-life of 30 to 40 hours. A slow onset & long duration of action means that Klonopin should have less risk of abuse than Xanax which has a fast action w/ "immediate gratification" & short duration which can easily lead to tolerance, & dose escalation by the patient.
I don't know much about Ativan except that it is the strongest of the available benzodiazepines & I believe it is more abuse prone because it has "immediate gratification" properties, & causes more coordination problems & falls in the elderly. My 81 year old grandmother, who worried constantly about everything, was prescribed Ativan. Eventually she started taking more pills than she was supposed to & fell asleep in a wooden chair in the kitchen & fell off, breaking her hip.

My 78 yr old mother has been a worrier all her life, but lately it's much worse. She gets panicky and agitates endlessly about every trival thing.
>
> The dr. at her nursing home is going to give an order for Xanax 0.25mg PRN. Is there a better alternative for older people?


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