The general rule is that if people receiving psychotropic drugs — hypnotics, tranquilizers, antidepressants, or antipsychotics — feel worse, then the first step should be to reduce the dose or discontinue the drug, rather than add another drug to the treatment regimen.
In a discussion on the use of tranquilizers and hypnotic drugs, World Health Organization (WHO) experts state the following:
“Anxiety is a normal reaction to stress and drug therapy should be started only in cases of excessive anxiety that makes normal living activities impossible. Long-term use … is ineffective, its should be avoided… Short-term use (less than two weeks) minimizes the risk of developing drug dependence.”
“They also made the following conclusion: “An elementary discussion of the causes of insomnia and anxiety, as well as informing the patient about the shortcomings of drug therapy often allows you to help patients without resorting to prescribing medications.”
Two studies of alternative therapies have convincingly shown that in the vast majority of cases, prescribing tranquilizers and sleeping pills is not necessary. The 90 patients, mostly suffering from anxiety, were randomly divided into two groups. The first group received the usual dose of the benzodiazepine group tranquilizer. The other group received alternative treatment, which included “listening, explaining, advising and calming down”. Both methods of treatment had equal efficacy, but patients of the second group were more satisfied with the results of treatment than patients of the group who received tranquilizers.
In the second study, patients with chronic anxiety were given one of three tranquilizers or a placebo (sugar pill). Evaluations of anxiety were conducted weekly by the patients themselves and professional experts, at the end of the month the results showed that “all four methods of treatment are identical in therapeutic efficacy in cases of marked anxiety.” Therefore, placebo is as effective as tranquilizers.
Faced with a fall in sibazon sales (VALIUM) in the early 1980s, Roche (and other manufacturers of this drug) began to pursue an aggressive advertising policy aimed at its use in older patients. A series of beautifully illustrated brochures called “Roche’s Aging Seminars” was distributed to doctors in 1982. Roche recommended sibazon as a suitable tool for older people with “limited” capabilities who suffer ”not only from their limited physical abilities, but also from social conditions and habitat. ” The advertising campaign has successfully worked, since the frequency of using tranquilizers in people 60 years and older between 1980 and 1985 has increased significantly, especially in older women.
The fact that more than 1.7 million people 65 years and older have used tranquilizers for at least a year on a daily basis is the best evidence of the abuse of these drugs. If we take into account that the efficacy of using such drugs for more than four months is questionable, the number of elderly people using tranquilizers for a longer period is staggering – the average number of tablets (160) that each of 10 million tranquilizers users is 60 years old and older buys a year, enough for a daily reception for more than 5 months.
Excessive or erroneous prescription of sleeping pills leads to the fact that about half a million people take such drugs daily for at least a month. Since it has not been proven that such remedies are effective for this or more time, all these patients subject their health without good reason.
The number of hypnotic drugs of the benzodiazepine group, which on average is prescribed to patients per year, is enough for five months, which is 5 – 10 times more than the time of their proven effectiveness. Therefore, hypnotic drugs are prescribed erroneously in 80 to 90% of use cases.
The increase in the frequency of using such tools became the subject of conclusions and recommendations in an extensive study of the Institute of Medicine of the National Academy of Sciences in 1979. Speaking of the use of such tools, the researchers conclude: “hypnotic drugs can have only limited use in ordinary medical practice: it is difficult to substantiate most prescription of sleeping pills. With standard outpatient treatment, the commission recommends the prescription of a very limited amount of the drug enough about to receive in a few days … Older patients sleeping pills should be prescribed with extreme caution and only occasionally. ”
Commenting on the specifics of the use of hypnotic drugs in the elderly, the authors note: “Regular and long-term use of this group of drugs is of particular concern, which has in itself a dubious therapeutic efficacy and leads to an increased risk of the development of negative effects from taking sleeping pills.”
Although older people more often than younger ones complain of sleep disturbances, studies have shown that the time of falling asleep does not increase with age, and the total time of sleep decreases very little, if at all. Insomnia most often occurs in older people who go to bed early and, moreover, often sleep during the day. Thus, the researchers conclude that “you need to give up daytime sleep instead of treating the nighttime insomnia caused by it.”
Dr. Marshall Folstein, a psychiatrist at Johns Hopkins Hospital and an Alzheimer’s disease expert, states that “it is extremely rare to find older people whom they (sleeping pills) are really needed.”
Another danger is the excessive dosage. A study of the dosages of sleeping pills showed that the majority (almost 80%) of people 65 years and older take flurazepam “excessive dose” (30 mg), although a dose of 15 mg is recommended for the elderly. (In this book, we included flurazepam in the “Do not use.” Category) Considering the recommendations of the National Academy of Sciences, which state that sleeping pills should be used only in a limited number of cases, the ever-increasing frequency of prescribing these medicines to older people – especially long periods of time -, represents a serious threat to their health.