“I'm taking Ativan?”
I have been taking 1mg Ativan per night--Dr thinks I should be on it- but it helps. I would like to take another during the day, but Dr has restricted me to 1 a day. I don`t need it all the time- but sometimes I need it during the day. I have a lot on my plate, please tell me will it hurt me to have another during the day PRN?
Female | 75 years old
2 Answers
Thanks for your question.
Ativan belongs to a class of medications called benzodiazepines. These medications are commonly used for anxiety and sleep and are considered "anxiolytic" medications because they are known to reduce anxiety. A side effect of these medications are somnolence or sleepiness which is why they are commonly used at night to help people sleep. Unfortunately, these medications are also habit forming, and after a person is on them for long enough, withholding the medication will produce withdrawal effects, and with these medications, it can be quite severe and include seizures and death. *When taken appropriately they produce a calming effect.* This class of medications is also one of several classes of medications
included in a list called "*Beer's criteria*" which are potentially dangerous in the elderly:
A panel of 13 experts reviewed more than 1,400 clinical trials and research studies published between 2017 and the last update in 2015. Across its five lists, the 2019 AGS Beers Criteria includes:
- *30 individual medications or medication classes to avoid for most older people.*
- *40 medications or medication classes to use with caution or avoid when someone lives with certain diseases or conditions.*
The AGS Beers Criteria aims to guide older people and health professionals away from potentially harmful treatments while helping us assess quality of care,” noted Todd Semla, MS, PharmD, BCGP, FCCP, AGSF, also a co-chair of the AGS Beers Criteria panel for 2019.
“The AGS Beers Criteria should never solely dictate how medications are prescribed, nor should it justify restricting health coverage. This tool works best as a starting point for a discussion—one guided by personal needs and priorities as we age,” added Michael Steinman, MD, a fellow co-chair of the AGS Beers Criteria panel.
In support of this principle, the AGS Beers Criteria panelists used their companion editorial (DOI: 10.111/jgs.15766 <https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.15766>) to reiterate that:
- Potentially inappropriate medications are just that—*potentially *inappropriate. They merit special scrutiny but should not be misconstrued as universally unacceptable in all cases or for all people.
- The caveats and rationales informing AGS Beers Criteria recommendations are as important as the recommendations themselves. Appreciating these nuances can help healthcare professionals know why medications are included on the lists, and how approaches to prescribing can be adjusted accordingly.
- Based on an extensive review of more than 1,400 studies, the 2019 AGS Beers Criteria includes five lists of nearly 100 medications or medication classes to avoid or use with caution for some or all older adults.
- The AGS Beers Criteria aims to guide older people and health professionals away from potentially harmful medications while also helping health systems recognize such decisions when assessing care quality. The AGS Beers Criteria should never solely dictate how medications are prescribed, nor should it serve as a justification for restricting health coverage.
- What this means is that people over 65 who are on these medications are at higher risk for an adverse event, including falls, which are a common reason for debility in the elderly.
- Your physician has deemed it appropriate for you to take this at night to sleep, but may not believe it is a safe medication for you to take during the day. It would be best to discuss this further with him. If it is a matter increased anxiety, there are far safer medications you could take during the day.
I hope this helps.
Ativan belongs to a class of medications called benzodiazepines. These medications are commonly used for anxiety and sleep and are considered "anxiolytic" medications because they are known to reduce anxiety. A side effect of these medications are somnolence or sleepiness which is why they are commonly used at night to help people sleep. Unfortunately, these medications are also habit forming, and after a person is on them for long enough, withholding the medication will produce withdrawal effects, and with these medications, it can be quite severe and include seizures and death. *When taken appropriately they produce a calming effect.* This class of medications is also one of several classes of medications
included in a list called "*Beer's criteria*" which are potentially dangerous in the elderly:
A panel of 13 experts reviewed more than 1,400 clinical trials and research studies published between 2017 and the last update in 2015. Across its five lists, the 2019 AGS Beers Criteria includes:
- *30 individual medications or medication classes to avoid for most older people.*
- *40 medications or medication classes to use with caution or avoid when someone lives with certain diseases or conditions.*
The AGS Beers Criteria aims to guide older people and health professionals away from potentially harmful treatments while helping us assess quality of care,” noted Todd Semla, MS, PharmD, BCGP, FCCP, AGSF, also a co-chair of the AGS Beers Criteria panel for 2019.
“The AGS Beers Criteria should never solely dictate how medications are prescribed, nor should it justify restricting health coverage. This tool works best as a starting point for a discussion—one guided by personal needs and priorities as we age,” added Michael Steinman, MD, a fellow co-chair of the AGS Beers Criteria panel.
In support of this principle, the AGS Beers Criteria panelists used their companion editorial (DOI: 10.111/jgs.15766 <https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.15766>) to reiterate that:
- Potentially inappropriate medications are just that—*potentially *inappropriate. They merit special scrutiny but should not be misconstrued as universally unacceptable in all cases or for all people.
- The caveats and rationales informing AGS Beers Criteria recommendations are as important as the recommendations themselves. Appreciating these nuances can help healthcare professionals know why medications are included on the lists, and how approaches to prescribing can be adjusted accordingly.
- Based on an extensive review of more than 1,400 studies, the 2019 AGS Beers Criteria includes five lists of nearly 100 medications or medication classes to avoid or use with caution for some or all older adults.
- The AGS Beers Criteria aims to guide older people and health professionals away from potentially harmful medications while also helping health systems recognize such decisions when assessing care quality. The AGS Beers Criteria should never solely dictate how medications are prescribed, nor should it serve as a justification for restricting health coverage.
- What this means is that people over 65 who are on these medications are at higher risk for an adverse event, including falls, which are a common reason for debility in the elderly.
- Your physician has deemed it appropriate for you to take this at night to sleep, but may not believe it is a safe medication for you to take during the day. It would be best to discuss this further with him. If it is a matter increased anxiety, there are far safer medications you could take during the day.
I hope this helps.
Ativan is Benzodiazepine drug, That can be use in elderly for short period of time. The Beers criteria was developed by an expert consensus panel in 1991. These criteria are a list of medications considered potentially inappropriate for use in older patients, mostly due to high risk adverse events such as alter mentation, falls with subsequent fracture and or even respiratory arrest, heart attack and death. These medications can produce dependency and patient will need higher doses to get the same effect. I hope i answer your question
