John Libbey Eurotext

Gériatrie et Psychologie Neuropsychiatrie du Vieillissement


Paradoxical reactions to benzodiazepines in the elderly Volume 19, issue 3, Septembre 2021

1 Université Lyon 1, Lyon, France
2 Centre Hospitalier Le Vinatier, Bron, France
3 Inserm U1028, CNRS UMR5292, Centre de recherche en neurosciences de Lyon, Lyon, France
4 Hôpital des Charpennes, Hospices Civils de Lyon, Lyon, France
5 Service pharmaceutique, Hôpital des Charpennes, Hospices Civils de Lyon, Lyon, France
6 Centre Mémoire Ressource et Recherche de Lyon (CMRR), Hôpital des Charpennes, Hospices Civils de Lyon, Lyon, France
7 Université Claude-Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), Inserm U1290, Lyon, France
8 CNRS UMR 5229, Institut des Sciences Cognitives Marc-Jeannerod, Team “Neuroplasticity in Parkinson's disease”
* Correspondance

The prevalence of paradoxical reactions to benzodiazepines is estimated of about 1% in the general population. The semiology can be very rich, diverse and misleading. Advanced age as well as cognitive disorders are classically described in the literature as risk factors for developing paradoxical reactions. However, the review of the literature has only identified a limited number of articles focusing on the elderly and only one article for patients with neurocognitive disorders. One may wonder about this paradox and whether these are unpublished clinical observations, or whether the elderly population is really at risk, especially patients with neurocognitive disorders. Semiology can be confused with underlying neurocognitive disorders. So, paradoxical reactions are ultimately only rarely or not evoked leading to a very high risk of iatrogeny. It is therefore important to be aware of these paradoxical effects in order to be able to evoke them quickly. The most striking semiological element would be the suddenness of onset of self-aggressive or hetero-aggressive behaviors.