2024 Volume 7 Issue 2 Pages 52-57
Adverse effects of benzodiazepines and nonbenzodiazepines include tolerance due to physical dependence, muscle relaxant effect, lightheadedness, and falls, which are particularly serious problems in the elderly. The conventional methods of discontinuation of these sleeping pills have been the tapering method, the every-other-day method, and the substitution method. However, there are few reports on the efficacy and safety of the substitution method in the elderly. Lemborexant, an orexin receptor antagonist, has attracted much attention because of the lack of adverse effects reported with benzodiazepines and nonbenzodiazepines. Trazodone has also been reported to reduce the frequency of awakenings and withdrawal symptoms. In the present study, we have conducted an outpatient analysis of an elderly patient on long-term benzodiazepine and nonbenzodiazepine sleeping pills who had been experiencing side effects such as periodic lightheadedness and carryover to the next day, and the patient was anxious about the side effects. Not only the conventional tapering method and the every-other-day method, but also the substitution method could be used without any side effects such as withdrawal symptoms and insomnia. The results also suggest that lemborexant and trazodone can be substitutes for benzodiazepines and nonbenzodiazepines without lowering sleep quality.
