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As an older adult, what should I know about taking anti-anxiety drugs?

As we age, drugs tend to be metabolized and absorbed more slowly, lingering longer in the body. This increases the risk for harmful effects even at doses considered safe for younger people. Also, older adults often take multiple medications, some of which can interact badly with drugs used for anxiety.

Because of the greater risk of side effects in older adults, doctors often prescribe anti-anxiety drugs in lower doses or recommend different therapies. When possible, benzodiazepines are avoided because they cause more side effects, such as sedation and impaired cognition, than some newer drugs, such as buspirone (BuSpar). If benzodiazepines are used, the best choices are the short-acting versions, such as lorazepam (Ativan), oxazepam (Serax), or temazepam (Restoril), which don't linger in the body as long as long-acting ones, such as diazepam (Valium), clonazepam (Klonopin), or chlordiazepoxide (Librium). In general, short-acting drugs cause less sedation and cognitive impairment, making them safer for people who need to drive.

Buspirone is thought to be safer than the benzodiazepines. It doesn't cause sedation or cognitive impairment, and it doesn't lead to adverse interactions when taken with a variety of drugs commonly used by older adults, including certain heart medications and drugs to control blood pressure. However, research on buspirone has been disappointing, with a number of studies finding it less effective than benzodiazepines in treating anxiety. And buspirone carries two other drawbacks: it takes several weeks to take effect, and it does not improve insomnia, a frequent complaint among older people with anxiety.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.