Tolerability of clonazepam in demented and non-demented geropsychiatric patients.
OBJECTIVE
The tolerability of clonazepam in geropsychiatric inpatients was examined in patients with and without a diagnosis of dementia.


METHODS
Forward-looking retrospective study comprising consecutive patients placed on clonazepam.


METHODS
A geropsychiatry unit of a large Veterans Affairs Medical Center.


METHODS
All geropsychiatry inpatients placed on clonazepam over a 21-month period of time.


METHODS
Mini-Mental State Examination, Brief Psychiatric Rating Scale, Cohen-Mansfield Agitation Inventory and the Rating Scale for Side Effects were performed at admission and discharge as part of an ongoing database.


RESULTS
Twenty-four geropsychiatric inpatients were treated with clonazepam (mean dose of 1.2 mg for a minimum of 2 weeks) during the 21 months studies. About one half of the patients had a primary diagnosis of dementia and the remainder had a diagnosis of an affective or psychotic disorder. Two of these patients were discontinued because they had responded to the acute need for clonazepam and a third patient was discontinued because of the development of sedation and confusion. For the remaining 21 patients, scores improved significantly on the Brief Psychiatric Rating Scale (p = 0.017), the Cohen-Mansfield Agitation Inventory (p = 0.011), the Rating Scale for Side Effects (0.004) and the Global Assessment of Functioning (p < 0.000), with no differences in amount of improvement between demented and non-demented patient groups. Scores on the Mini-Mental State Examination remained unchanged.


CONCLUSIONS
Clonazepam shows promise as a benzodiazepine with good tolerability in the elderly.
Calkin
P A
PA
Baylor College of Medicine, Department of Psychiatry, Houston, USA.
Kunik
M E
ME
Orengo
C A
CA
Molinari
V
V
Workman
R
R
D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy; D002998:Clonazepam / Q000009:adverse effects / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy*; D005852:Geriatric Psychiatry; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012890:Sleep / Q000187:drug effects; D012894:Sleep Stages; D016896:Treatment Outcome
D000927:Anticonvulsants; D002998:Clonazepam