TOLERABILITY OF CLONAZEPAM IN DEMENTED AND NONDEMENTED GEROPSYCHIATRIC PATIENTS

Objective. The tolerability of clonazepam in geropsychiatric inpatient s was examined in patients with and without a diagnosis of dementia. D esign. Forward-looking retrospective study comprising consecutive pati ents placed on clonazepam. Setting. A geropsychiatry unit of a large V eterans Affairs Medical Center. Patients. All geropsychiatry inpatient s placed on clonazepam over a 21-month period of time. Measure. Mini-M ental State Examination, Brief Psychiatric Rating Scale, Cohen-Mansfie ld Agitation Inventory and the Rating Scale for Side Effects were perf ormed at admission and discharge as part of an ongoing database. Resul ts. Twenty-four geropsychiatric inpatients were treated with clonazepa m (mean dose of 1.2 mg for a minimum of 2 weeks) during the 21 months studied. About one half of the patients had a primary diagnosis of dem entia and the remainder had a diagnosis of an affective or psychotic d isorder. Two of these patients were discontinued because they had resp onded to the acute need for clonazepam and a third patient was discont inued because of the development of sedation and confusion. For the re maining 21 patients, scores improved significantly on the Brief Psychi atric Rating Scare (p = 0.017), the Cohen-Mansfield Agitation Inventor y (p = 0.011), the Rating Scale for Side Effects (0.004) and the Globa l Assessment of Functioning (p < 0.000), with no differences in amount of improvement between demented and non-demented patient groups. Scor es on the Mini-Mental State Examination remained unchanged. Conclusion . Clonazepam shows promise as a benzodiazepine with good tolerability in the elderly. (C) 1997 by John Wiley & Sons, Ltd.