How might the dosage of alprazolam be adjusted in an older adult client and why?

• A. Higher doses due to slower metabolism
• B. Older adult clients are sensitive to benzodiazepines and, therefore, lower doses may be used in this population.
• C. Same dose as younger adults
• D. Not used

Answer: (B)

In older adults, benzodiazepines affect the body more strongly and for longer. Aging often slows metabolism and clearance, so alprazolam can accumulate and cause deeper, longer-lasting sedation. At the same time, older people are more sensitive to central nervous system depressants, which raises the risk of confusion, dizziness, cognitive impairment, and, importantly, falls. Because of these factors, the best approach is to use the lowest effective dose and slow, careful titration, aiming for the shortest duration possible. This minimizes adverse effects while still providing potential benefit. While some guidelines discourage routine use of benzodiazepines in the elderly, if they are necessary, starting with a lower dose and monitoring closely is essential.