Prolonged Use of Benzodiazepines in the Elderly: Adverse Effects, Clinical Implications and Management Recommendations

• DOI: https://doi.org/10.22533/at.ed.1595272529073

• Palavras-chave: Benzodiazepines; Elderly; Adverse effects; Overprescription; Geriatrics.

• Keywords: Benzodiazepines; Elderly; Adverse effects; Overprescription; Geriatrics.

• Abstract:

  The prolonged use of benzodiazepines (BZDs) among elderly individuals is still a recurring practice in clinical practice, despite recommendations to the contrary issued by various national and international scientific societies. These drugs, usually prescribed for sleep disorders, anxiety disorders and other psychiatric conditions, have a proven association with significant adverse effects, such as excessive sedation, cognitive impairment, increased risk of falls, development of chemical dependency and greater demand for health services. The maintenance of prolonged prescription is often related to the presence of psychiatric comorbidities, barriers to de-prescription and the absence of structured clinical protocols. The aim of this integrative review was to analyze the adverse effects resulting from the chronic use of BZDs in the elderly, discuss their clinical implications and present current management recommendations, based on the evidence available in the scientific literature, conducted through a systematized search in the PubMed and SciELO databases, in addition to consulting official documents from the Ministry of Health and Brazilian medical societies. Twenty references considered central were included, published between 2017 and 2025, with an emphasis on clinical guidelines and highly relevant observational studies. The results show that, despite the well-documented risks, the continued use of benzodiazepines remains high in this population. It is therefore essential to implement safe and individualized deprescribing strategies, combined with ongoing education for health professionals and the adoption of non-pharmacological therapeutic approaches. These measures are fundamental for promoting healthy ageing, with a focus on therapeutic safety and rationalizing the use of medicines in the elderly.