Treatment of Older Adults with Insomnia, Agitation, or Delirium with Benzodiazepines: Clinical Effectiveness and Guidelines

Question

1. What is the clinical effectiveness of the treatment of older adults with insomnia, agitation, or delirium with benzodiazepines or other sedative hypnotic agents?
2. What are the evidence-based guidelines for the treatment of older adults with insomnia, agitation, or delirium with benzodiazepines or other sedative hypnotic agents?

Key Message

In older adults, low dose doxepin (up to 6 mg daily) appears to be more effective than placebo for the short-term treatment of insomnia. The short-term incidence of adverse effects with doxepin and placebo appears to be similar; however no conclusions can be drawn due to limitations in the evidence available. No studies or evidence-based guidelines were identified on the use of benzodiazepines or other sedative hypnotics in older adults.