Opções farmacológicas para mitigar os efeitos deletérios de benzodiazepínicos em idosos: o que diz a literatura científica?

Pharmacological options to mitigate the harmful effects of benzodiazepines in the elderly: what the scientific literature says?

Abstract

Benzodiazepines are sedative-hypnotic medications widely used by the general public to treat generalized anxiety and insomnia. Due to their low cost, high effectiveness, and ease of access through the Sistema Único de Saúde (SUS), they are usually easily prescribed, especially for the elderly. However, their side effects are substantial and enhanced with chronic use. Drugs such as zolpidem and quetiapine have received attention from the scientific community due to the possible mitigation of these side effects. Thus, the present literature review outlined four scientific information search strategies combining the words “elderly,” “benzodiazepines”, “zolpidem,” “quetiapine,” “sleep disorders,” and “anxiety” in several databases. The prevalence of benzodiazepine use is among women aged over 60 years, with low family income, reduced education, and chronic disease. Zolpidem and quetiapine appear to have reduced side effects when compared to benzodiazepines, but there is a lack of studies with robust data and prolonged monitoring time for elderly patients. Given the information above, there is an urgent need for research and development of drugs with different mechanisms of action that can adequately treat anxiety disorders and sleep disorders in elderly patients.