Adverse performance effects of acute lorazepam administration in elderly long-term users: Pharmacokinetic and clinical predictors.

Pomara, Nunzio and Lee, Sang Han and Bruno, Davide and Silber, Timothy and Greenblatt, David J and Petkova, Eva and Sidtis, John J. (2015) Adverse performance effects of acute lorazepam administration in elderly long-term users: Pharmacokinetic and clinical predictors. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 56. pp. 129-135.

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Abstract

The benzodiazepine lorazepam is widely utilized in the treatment of elderly individuals with anxiety disorders and related conditions. Negative effects of acute lorazepam administration on cognitive performance, especially memory, have been reported in both previously untreated elderly and in individuals who have received short term (up to three weeks) treatment with therapeutic doses. However, it remains unclear if these adverse cognitive effects also persist after long-term use, which is frequently found in clinical practice. Cognitively intact elderly individuals (n=37) on long-term (at least three months) daily treatment with lorazepam were studied using a double-blind placebo-controlled cross-over study design. Subjects were administered their highest daily unit dose of lorazepam (0.25 – 3.00 mg) and placebo on different days, approximately 1 week apart in a random order, and were assessed on memory, psychomotor speed, and subjective mood states. Subjects had significantly poorer recall and slowed psychomotor performance following acute lorazepam administration. There were no significant effects on self-ratings of mood, sedation, or anxiety in the whole group, but secondary analyses suggested a differential response in subjects with GAD. Reduced recall and psychomotor slowing following acute lorazepam administration in long-term users reinforces the importance of cognitive toxicity as a clinical factor in benzodiazepine use.

Item Type:	Article
Additional Information and Comments:	NOTICE: this is the author’s version of a work that was accepted for publication in Progress in Neuro-Psychopharmacology and Biological Psychiatry. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Progress in Neuro-Psychopharmacology and Biological Psychiatry, 56, January 2015, DOI#10.1016/j.pnpbp.2014.08.014
Faculty / Department:	Faculty of Human and Digital Sciences > School of Psychology
Depositing User:	Anna Kirpichnikova
Date Deposited:	02 Nov 2015 18:31
Last Modified:	16 Oct 2017 19:04
URI:	https://hira.hope.ac.uk/id/eprint/454

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