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View Diary: Her name was Kirsten. (108 comments)

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  •  You're very welcome--but! (1+ / 0-)
    Recommended by:
    StellaRay

    As for your elderly mother: lorazepam is an unusual choice for a sleep aid. Benzodiazepines in general are considered potentially inappropriate for elderly people, because these drugs increase the risk of falls.

    Also, benzodiazepines are prescribed much less frequently as sleeping pills than they used to be, because several non-benzodiazepine sleeping pills have come on the market. The choice depends somewhat on whether the problem is falling asleep, staying asleep, or both. For example:
    -Sonata (zaleplon) or Ambien (zolpidem) for falling asleep
    -Ambien-CR for both falling asleep and staying asleep
    -Lunesta (eszopiclone), for both

    Plus, a fairly new drug, Rozerem (ramelteon), works like melatonin. Supposedly it leaves you not at all groggy the next morning, and studies on elderly patients have shown no impairment in night balance, mobility, or memory.

    Last but not least, there's a nonprescription alternative: the combination of melatonin (5 mg), magnesium (225 mg), and zinc (11.25 mg), taken 1 hour before bedtime. (Exact amounts of the 3 ingredients may not matter.) A study in nursing home patients found this very effective.

    Unless your mother is completely satisfied with what she's doing now, she may want to ask her doctor about some of these other drugs. One possible major drawback: I have no idea how much these drugs cost.

    Oh, and if you're wondering just who I am, to be making these suggestions: In addition to being Some Person On The Internet, I'm a registered nurse and a medical editor. I worked on an article on insomnia just a few months ago.

    Cheers!

    •  Thank you for this great information. (0+ / 0-)

      I have bookmarked your comment and will share it with my mother. She has tried Ambien, Lunesta and Sonata and had issues with all of them. So the Ativan was not the first choice, but I should note that she has big anxiety issues, particularly at night. She has had no problems with it, no side effects, and no falls.  She is sleeping well, and feeling good when she awakes.  My brother is a doctor and he has questioned this too, but after talking to her doctor, he withdrew his complaints.

      And actually, my experience when I've taken Ativan  has been so gentle, that other than the panic receding I have no sense of being on a drug at all.

      Still, I'm absolutely going to share this with her, and have her discuss it with her doctor, if I can talk her into it.  Because even though she has not suffered falls, and is very careful, uses her walker etc, it's certainly a concern for someone who is 85.  She will not happily give up her regime because she has suffered so from lack of sleep in the past, tried so many things that didn't work for her, and now feels like she's finally got the thing that works.  We'll see how it goes.

      In any case, I really appreciate the time and effort you too, to help me be better informed about the options.

      "A typical vice of American politics is the avoidance of saying anything real on real issues." Theodore Roosevelt.

      by StellaRay on Thu Dec 06, 2012 at 07:29:51 PM PST

      [ Parent ]

      •  Just now saw your response (0+ / 0-)

        I'll say this for your mother: she appears to have raised a wonderfully devoted daughter.

        I'm relieved to see that Ativan and your mother looks like an "if it ain't broke, don't fix it" situation. Ativan may be a poor choice for 9 out of 10 elderly patients, but apparently your mother is that 10th sort.

        And it sounds like her doctor is aware of current practice (having tried her on the standard sleepers) but sensible enough to realize that sometimes you have to bend the rules to fit an individual patient's situation.

        I find it especially reassuring that Ativan works very gently for you. I'm guessing that your reaction to the drug is genetically mediated--like mother, like daughter.

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