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A 54-year-old male asked:

is recommended for a 93 years patient with vascular dementia take a hipnotic drug with clonazepan for insomnio?

2 doctor answers4 doctors weighed in
Dr. Matthew Kozminski
Neurology 16 years experience
I'd prefer to use: Trazodone for dementia patients; however, sometimes that just fails. I would only treat if they are belligerent at night. If the dose of Clonazepam and very small, works, and they do not have any major side effects, then acceptable.
Dr. Maureen Nash
Geriatric Psychiatry 24 years experience
Trazodone is anticholinergic and can increase confusion in those with dementia. It also increases fall risk and risk of orthostatic hypotension so needs to be monitored closely
Feb 10, 2014
Dr. Maureen Nash
Geriatric Psychiatry 24 years experience
Complex: Sleep problems are common in older adults and even more common in those with dementia. Causes of sleep problems are varied and as dementia progresses they change. Getting enough exercise early in the day is helpful. Many sleeping medications worsen confusion or cause side effects in those with dementia. Melatonin or warm decaf tea have minimal risk. Some antidepressants can help at least for awhil.

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Last updated Jun 24, 2014
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