Toxicity of nitrazepam in the elderly: a report from the Boston Collaborative Drug Surveillance Program

British Journal of Clinical Pharmacology
David J Greenblatt, M D Allen

Abstract

1 To assess the potential hazards of nitrazepam therapy of insomnia in the elderly, adverse reactions to nitrazepam were studied in 2111 hospitalized medical patients who received the drug. 2 Manifestations of unwanted central nervous system (CNS) depression (such as drowsiness or 'hangover') were reported in 49 nitrazepam recipients (2.3%), and signs of unwanted CNS stimulation (such as nightmares, insomnia, agitation, etc.) in 15 (0.7%). None of the adverse reactions were considered serious. 3 Physician-rated clinical efficacy of nitrazepam was not related to dose, but the frequency of both types of adverse reactions increased significantly at higher daily doses. CNS depression also was significantly more frequent in the elderly, being reported in 11% of those aged 80 years or older, whereas the frequency of CNS stimulation was not correlated with age. 4 The effect of age on the reported rate of unwanted CNS depression was most striking at high doses. Among patients aged 80 years or over whose daily dose averaged 10 mg or more, 55% experienced unwanted CNS depression attributed to nitrazepam. 5 Low doses of nitrazepam are safe for elderly individuals, but the elderly are readily susceptible to excessive CNS depression at high...Continue Reading

References

Mar 1, 1977·Clinical Pharmacology and Therapeutics·David J GreenblattRichard I Shader
Mar 1, 1976·JAMA : the Journal of the American Medical Association·K A Arndt, H Jick
Jan 1, 1977·British Medical Journal·C M CastledenC Hallett
Mar 4, 1976·The New England Journal of Medicine·J Koch-Weser, E M Sellers
Feb 1, 1976·Journal of Medical Genetics·A K Karim, D A Evans
May 1, 1976·Archives of Neurology·T R Browne
Nov 1, 1977·Journal of Clinical Pharmacology·Richard I ShaderJ Koch-Weser
May 1, 1976·The American Journal of the Medical Sciences·H J PfeiferJ Koch-Wester
Feb 5, 1976·The New England Journal of Medicine·J Koch-Weser, E M Sellers
Feb 1, 1975·The Journal of Clinical Investigation·U KlotzG R Wilkinson
Dec 5, 1974·The New England Journal of Medicine·David J Greenblatt, Richard I Shader
Oct 17, 1974·The New England Journal of Medicine·H Jick
Feb 5, 1972·The Medical Journal of Australia·R MearesL E Oliver
May 1, 1974·The British Journal of Psychiatry : the Journal of Mental Science·A MalpasD F Scott
Nov 25, 1972·British Medical Journal·J G Evans, E H Jarvis
Feb 10, 1973·British Medical Journal·R H Girwood
Jan 27, 1973·British Medical Journal·F Wells
May 26, 1973·British Medical Journal·T GoossensE Wakeling
Feb 26, 1971·Nature·A J Walters, M H Lader
May 1, 1972·The British Journal of Psychiatry : the Journal of Mental Science·F Winston
Feb 1, 1970·Journal of the American Geriatrics Society·K Dawson-Butterworth
Nov 9, 1975·Drug Intelligence & Clinical Pharmacy·M D Allen, David J Greenblatt

Citations

Oct 1, 1979·Journal of Clinical Pharmacology·R R Miller, David J Greenblatt
Jan 1, 1988·European Journal of Clinical Pharmacology·L Nolan, K O'Malley
Jan 1, 1987·European Journal of Clinical Pharmacology·C M CastledenP St John-Smith
Aug 17, 1981·Klinische Wochenschrift·H R OchsH Otten
Nov 1, 1983·Archives of Gerontology and Geriatrics·K Morgan
Oct 1, 1984·Archives of Gerontology and Geriatrics·C J GilleardK Morgan
Feb 1, 1993·Social Science & Medicine·D IsacsonM Dahlström
Dec 17, 2004·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Stefan MathiasMarike Lancel
May 3, 1979·The New England Journal of Medicine·M E Lippman, J C Allegra
May 6, 1982·The New England Journal of Medicine·David J GreenblattRichard I Shader
Mar 1, 1994·Journal of Sleep Research·K Morgan
Jan 1, 1992·Scandinavian Journal of Caring Sciences·M L SvenssonA Rundgren
Mar 1, 1990·The Journal of Pharmacy and Pharmacology·R Martínez JordáS Erill
Jun 1, 1992·The Journal of Pharmacy and Pharmacology·I TorresR Calvo
Dec 1, 1988·American Journal of Public Health·P A RobersB L Svarstad
Apr 1, 1985·Postgraduate Medical Journal·A J Bayer, M S Pathy
Mar 1, 1980·British Medical Journal·R S BriggsC A Kraft
Sep 1, 2004·Expert Opinion on Drug Safety·Subramoniam Madhusoodanan, Olivera J Bogunovic
Jan 1, 1983·Drug Metabolism Reviews·David J GreenblattRichard I Shader
Jan 1, 1984·Current Medical Research and Opinion·R BanderaS Garattini
Aug 1, 1987·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·S FordD C Rangedara
Dec 5, 2009·The American Journal of Medicine·Sarah N HilmerHealth ABC Study
Sep 23, 2006·Brain Research·Jeanne M FaheyDavid J Greenblatt
Oct 1, 1989·Journal of Clinical Pharmacology·David J GreenblattJerold S Harmatz
Nov 1, 1982·Journal of the American Geriatrics Society·David J GreenblattRichard I Shader
Feb 1, 1988·Journal of the American Geriatrics Society·L Nolan, K O'Malley
Jan 1, 1983·British Journal of Clinical Pharmacology·H BeckJ Holzer
Jan 1, 1983·British Journal of Clinical Pharmacology·O von DelbrückC Nagel
Mar 1, 1983·British Journal of Clinical Pharmacology·R JochemsenD D Breimer
Aug 1, 1985·British Journal of Clinical Pharmacology·C G SwiftI H Stevenson
Aug 1, 1985·British Journal of Clinical Pharmacology·C G SwiftJ Robinson
Jan 1, 1982·Journal of the American Geriatrics Society·W C DementM A Carskadon
Oct 25, 2000·International Journal of Geriatric Psychiatry·G M BattyS H Jackson
Jan 5, 1985·British Medical Journal
Jan 10, 1981·British Medical Journal·L E Ramsay, G T Tucker
Jan 1, 1986·Acta Psychiatrica Scandinavica. Supplementum·C G Swift
Jan 1, 1986·Acta Psychiatrica Scandinavica. Supplementum·A J BayerM J Stoker
Jan 1, 1986·Acta Psychiatrica Scandinavica. Supplementum·P J Cook
Apr 26, 2020·Journal of Clinical Psychopharmacology·David J GreenblattRichard I Shader
Mar 1, 1983·Klinische Wochenschrift·H R Ochs
Apr 1, 1993·The Annals of Pharmacotherapy·N Takami, A Okada
Aug 1, 1979·Journal of the American Geriatrics Society·W E HaleR B Stewart
Jan 1, 1985·Drug Intelligence & Clinical Pharmacy·W E HaleR G Marks
Jan 1, 1988·Community Health Studies·A GilbertN Owen
Nov 1, 1985·Pharmacotherapy·F PucinoI L Silbergleit
Feb 1, 1986·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·H MoldofskyF A Lue
Jan 1, 1986·Acta Psychiatrica Scandinavica. Supplementum·M S PathyM J Stoker
May 1, 1991·The Journal of International Medical Research·D SchlichH J Kryrein

Related Concepts

Senility
Transient Insomnia
Imeson

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Genetic Screens in iPSC-derived Brain Cells

Genetic screening is a critical tool that can be employed to define and understand gene function and interaction. This feed focuses on genetic screens conducted using induced pluripotent stem cell (iPSC)-derived brain cells. It also follows CRISPR-Cas9 approaches to generating genetic mutants as a means of understanding the effect of genetics on phenotype.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Pediculosis pubis

Pediculosis pubis is a disease caused by a parasitic insect known as Pthirus pubis, which infests human pubic hair, as well as other areas with hair including eye lashes. Here is the latest research.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Rh Isoimmunization

Rh isoimmunization is a potentially preventable condition that occasionally is associated with significant perinatal morbidity or mortality. Discover the latest research on Rh Isoimmunization here.

Pharmacology of Proteinopathies

This feed focuses on the pharmacology of proteinopathies - diseases in which proteins abnormally aggregate (i.e. Alzheimer’s, Parkinson’s, etc.). Discover the latest research in this field with this feed.

Enzyme Evolution

This feed focuses on molecular models of enzyme evolution and new approaches (such as adaptive laboratory evolution) to metabolic engineering of microorganisms. Here is the latest research.

Alignment-free Sequence Analysis Tools

Alignment-free sequence analyses have been applied to problems ranging from whole-genome phylogeny to the classification of protein families, identification of horizontally transferred genes, and detection of recombined sequences. Here is the latest research.