Weaning the Elderly off Sleeping Pills

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In a follow-up to an earlier commentary on the topic, Paula Span discusses the widespread use and negative effects of sleeping pills among the elderly in long-term care in the New York Times, including falls and hospitalizations for adverse drug reactions. She also discusses a new study of tapering attempts. “Of the group that attempted to gradually stop the drug, more than half succeeded, and another 22 percent reduced their dosage,” writes Span. “Among those who didn’t make the attempt, the greatest reason — get this — was discouragement from their physicians or pharmacists.”


More on Sleeping Pills and Older Adults (The New York Times, July 30, 2014)

Weaning Older Patients Off Sleeping Pills (The New York Times, July 2, 2014)

8 COMMENTS

    • In my research, I’ve found the NY Times to be the ONLY mainstream paper that regularly covers the issues we discuss on MIA. I, too, am glad they publish information on ADRs of pharmaceuticals, but this is an enormous societal problem.

      It should be making the front pages of all the papers that medical “mistakes” are at least the third largest killer of Americans, and properly prescribed pharmaceuticals are killing over a 100,000 Americans a year. How many American soldiers were killed in action last year?

      Truly, it seems we are dealing with a form of “chemical warfare” against the American public, by misinformed or unethical “American” doctors. And they’re targeting our best and brightest children, not to mention, our war heroes. Plus the many others who didn’t choose to go to medical school.

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  3. As one who has suffered severe sleep deprivation for various reasons, I have a different take on the New York Time articles.

    Having gone through h–ll from this, if I had found a med that worked which I haven’t and it gave me substantial relief, I would have not been any more happy with professionals with anti med biases than I was with ones who wanted to medicate me to the gills. Either way, the issue is providing fully informed consent and letting the patient make the decision as to what works best for him/her.

    Additionally, if you take people off of a sleep meds who have been on them for a very long time, you risk substantial adverse affects that may be worse than if you had left them on the drugs. The could also impact sleep which then would leave the elderly with a lot of hurt.

    Maybe B, that is why doctors and pharmacists discouraged them from tapering. I know it is easy to think the worse about their motives as I definitely am prone to do that. But I think we have to try not to do that even though it is easier said than done.

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    • Well, I doubt there are many people out there who take that into consideration, especially that tampering people of the sleeping pills (which are also addictive) is not an easy thing and it’s much simpler to just tell them to keep taking the pills. It’s like saying: “we put your health and maybe even life in jeopardy by making stupid decisions in the past and now you’re stuck with the consequences”. Putting so many elderly people on such meds to begin with is problematic to say the least. There are of course cases when this is adviceable, just like with any psych meds, but in most cases there are other things to do – behavioural changes or herbal teas (like melissa tea). Also giving people psych drugs and sleeping pills as a way to deal with insomia induced by other drugs is irresponsible in many cases.

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      • B,

        Of course, in many cases they should have never have been put on the drugs to begin with but the issue is, you have to deal with the current situation no matter how irresponsible providers were in the past. And the person who is taking the meds should be given a fully informed choice as to what the best option is whether it is stay on the meds or get off of them. It should be their choice and not the one of the healthcare provider just like when we want our choices respected to not take meds.

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    • I had a grand mal seizure discontinuing clonazepan as prescribed. The risks are considerable, but a person usually has to be off of the medication before they can clearly see what detrimental effects it had when it did cause more problems than it solved.

      Getting off baclofen made it clear to me that most of what I thought was the degenerative effects of MS was the effects of the drugs. Previously, I discovered that hormone replacements relieved about 95% of the pain above my ankles (the ankles and feet are purely MS pain) and made what pain was left much more manageable. The pain and other effects of menopause + hypervigilance and other death related stresses led to my first psychotic episode.

      I need 8 to 10 hours of sleep every night, without fail in order to be fully functioning and always have. Of course, pain interferes with sleep and so does hot flashes and night sweats. I’ve asked for a higher dose of Prempro in the hopes that it will get rid of the residual aches.

      Our whole selves should be treated. Sleep and sleeplessness is complex and the causes of insomnia and early waking are legion. But one thing that people who are too sold on a 9 to 5 ethos needs to learn is that sleeping for eight hours straight is a new demand in the pantheon of human sleep patterns. For people who must sleep straight through in order to function at work, there can certainly be compelling reasons to take drugs during times of difficulty with sleeping. But like many drugs, hypnotics tend to induce agnosia and the addictive nature of the benzos and possibly horrific withdrawal effects make quitting hard, and for some people, very dangerous.

      Someone in the comment section of “Weaning Older Patients Off Sleeping Pills” linked to this website for people who want to get off benzos:

      http://www.benzo.org.uk/manual/bzcha02.htm

      Sometime after my seizure a more conservative schedule was recommended which included taking lower doses every other day. It clearly needs to be more slow and drug companies need to make smaller doses for this purpose. It is in conflict with their bottom line but is the socially and medically responsible thing to do.

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