Agitation in the Demented Elderly: A Role for Benzodiazepines?

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“Agitation” is a term that is used to describe a wide range of dysfunctional behaviours in geriatric populations. The term is so widely used that in many cases it loses clinical meaning and therefore a more restricted use of the term is suggested. When patients with agitation are identified it is important to look for underlying treatable pathology which is often present. Controversy surrounding the most appropriate medications is reviewed with particular reference to both neuroleptics and benzodiazepines. A randomized double-blind comparison of lorazepam and alprazolam in demented patients with agitation was earned out. While both drugs were efficacious for some patients, there were significantly more serious side-effects with lorazepam. It appears that there is a role for benzodiazepines such as alprazolam in the management of the agitated demented patient.

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