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 Aairs 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-Mansยฎeld Agitation Inventory and the Rating Scale for Side Eects 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 studied. About one half of the patients had a primary diagnosis of dementia and the remainder had a diagnosis of an aective 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 signiยฎcantly on the Brief Psychiatric Rating Scale ( p 0X017), the Cohen-Mansยฎeld Agitation Inventory ( p 0X011), the Rating Scale for Side Eects (0.004) and the Global Assessment of Functioning ( p `0X000), with no dierences in amount of improvement between demented and non-demented patient groups. Scores on the Mini-Mental State Examination remained unchanged.
Conclusion. Clonazepam shows promise as a benzodiazepine with good tolerability in the elderly.