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.

DESIGN

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

SETTING

A geropsychiatry unit of a large Veterans Affairs Medical Center.

PATIENTS

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

MEASURE

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.