NDLI: Adverse performance effects of acute lorazepam administration in elderly long-term users: pharmacokinetic and clinical predictors.

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Adverse performance effects of acute lorazepam administration in elderly long-term users: pharmacokinetic and clinical predictors.

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Adverse performance effects of acute lorazepam administration in elderly long-term users: pharmacokinetic and clinical predictors.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Pomara, Nunzio Lee, Sang Han Bruno, Davide Silber, Timothy Greenblatt, David J. Petkova, Eva Sidtis, John J.
Description	Author Affiliation: Pomara N ( Nathan Kline Institute, Orangeburg, NY, USA); Lee SH ( Nathan Kline Institute, Orangeburg, NY, USA.); Bruno D ( Nathan Kline Institute, Orangeburg, NY, USA); Silber T ( Nathan Kline Institute, Orangeburg, NY, USA); Greenblatt DJ ( Tufts University School of Medicine, Boston, MA, USA.); Petkova E ( Nathan Kline Institute, Orangeburg, NY, USA); Sidtis JJ ( Nathan Kline Institute, Orangeburg, NY, USA)
Abstract	BACKGROUND: The benzodiazepine lorazepam is widely utilized in the treatment of elderly individuals with anxiety disorders and related conditions. Negative effects of acute lorazepam administration on cognitive performance, especially memory, have been reported in both previously untreated elderly and in individuals who have received short term (up to three weeks) treatment with therapeutic doses. However, it remains unclear if these adverse cognitive effects also persist after long-term use, which is frequently found in clinical practice. METHODS: Cognitively intact elderly individuals (n=37) on long-term (at least three months) daily treatment with lorazepam were studied using a double-blind placebo-controlled cross-over study design. Subjects were administered their highest daily unit dose of lorazepam (0.25-3.00 mg) or placebo on different days, approximately 1 week apart in a random order, and were assessed on memory, psychomotor speed, and subjective mood states. RESULTS: Subjects had significantly poorer recall and slowed psychomotor performance following acute lorazepam administration. There were no significant effects on self-ratings of mood, sedation, or anxiety in the whole group, but secondary analyses suggested a differential response in subjects with Generalized Anxiety Disorder. CONCLUSIONS: The reduced recall and psychomotor slowing that we observed, along with an absence of significant therapeutic benefits, following acute lorazepam administration in elderly long-term users reinforces the importance of cognitive toxicity as a clinical factor in benzodiazepine use, especially in this population.
File Format	HTM / HTML
ISSN	02785846
e-ISSN	18784216
DOI	10.1016/j.pnpbp.2014.08.014
Journal	Progress in Neuro-Psychopharmacology and Biological Psychiatry
Volume Number	56
Language	English
Publisher	Elsevier
Publisher Date	2015-01-02
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Psychiatry Anti-anxiety Agents Adverse Effects Pharmacokinetics Lorazepam Memory Disorders Chemically Induced Psychomotor Performance Drug Effects Anxiety Blood Drug Therapy Cross-over Studies Double-blind Method Emotions Longitudinal Studies Neuropsychological Tests Psychiatric Status Rating Scales Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Biological Psychiatry Pharmacology

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