Question

An 82-year-old woman with a history of falls and mild cognitive impairment reports chronic insomnia. She requests a prescription for a benzodiazepine that her friend finds helpful. According to Choosing Wisely Canada and geriatric prescribing guidance, what is the most appropriate response?

Accepted Answer

Explain that benzodiazepines increase risks of falls, cognitive impairment and dependence in older adults, and recommend non-pharmacologic sleep strategies and CBT for insomnia

Answer

Prescribe a short-acting benzodiazepine at bedtime

Answer

Prescribe a long-acting benzodiazepine because it has fewer withdrawal symptoms

Answer

Prescribe zopiclone as it is safer than benzodiazepines

Answer

Advise over-the-counter diphenhydramine at bedtime

Practice question

An 82-year-old woman with a history of falls and mild cognitive impairment reports chronic insomnia. She requests a prescription for a benzodiazepine that her friend finds helpful. According to Choosing Wisely Canada and geriatric prescribing guidance, what is the most appropriate response?