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Übersichtsarbeit

Suchtpotenzial und andere Risiken von Benzodiazepinen und Z-Drugs im Alter

Published Online:https://doi.org/10.1024/0939-5911/a000474

Zusammenfassung.Zielsetzung: Übersicht über Suchtpotenzial und andere Risiken von Benzodiazepinen (BZD) und Z-Drugs sowie die Behandlung der Abhängigkeit von diesen Substanzen im Alter. Methodik: Narrativ Review. Literaturrecherche in PubMed (Suchbegriffe: Benzodiazepin*, z-drugs, zolpidem, zopiclon*, jeweils UND old sowie elderly) und aktuellen einschlägigen Standardwerken; Auswahl nach altersmedizinischer Relevanz und Aktualität. Ergebnisse: BZD werden weiterhin im Alter häufig verordnet. Z-Drugs haben zu einem großen Teil BZD-Hypnotika ersetzt. Neben der Niedrigdosisabhängigkeit werden beide mit der Auslösung einer Reihe von Gesundheitsstörungen in Verbindung gebracht, darunter auch Demenzen. Z-Drugs stellen keinen prinzipiellen Fortschritt gegenüber BZD dar. Ein Entzug ist auch im Alter möglich, bedarf aber sorgfältiger Vorbereitung. Schlussfolgerungen: BZD und Z-Drugs sind nach wie vor ein wichtiges Thema für die Altersmedizin.


Dependence liability and other risks of benzodiazepines and z-drugs in old age

Abstract. Objective: To review dependence liability and other adverse effects of benzodiazepines (BZD) and z-drugs as well as the treatment of dependency of these drugs in old age. Methods: The author employed a narrative review and did a literature search in PubMed (terms: benzodiazepin*, z-drugs, zolpidem, zopiclon*, for each term AND old and elderly, respectively) as well as in more recent relevant textbooks. Selection was made with respect to salience from a geriatric viewpoint and topicality. Results: Use of BZD remains common in old age. Z-drugs, however, have now largely replaced BZD hypnotics. Besides low-dose dependency, both are suspected of causing several health problems including dementia. Z-drugs do not represent a fundamental step forward over BZD: Withdrawal is possible even in old age, but thorough preparation thereof is mandatory. Conclusions: BZD and z-drugs are still important issues in geriatrics.

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