Psychomotor dysfunction

This includes cognitive impairment, decreased psychomotor skills, and unwanted daytime sedation. These are more common with benzodiazepines that have active metabolites with long half-lives (eg, diazepam, flurazepam), but can also occur after a single dose of a short-acting benzodiazepine such as triazolam. The dosage of a sedative-hypnotic should be reduced in elderly patients, who are more susceptible to drugs that cause psychomotor dysfunction. In such patients excessive daytime sedation has been shown to increase the risk of falls and fractures. Anterograde amnesia may also occur with benzodiazepines, especially when used at high dosage, an action that forms the basis for their criminal use in cases of “date rape.” Zolpidem and the newer hypnotics cause modest day-after psychomotor depression with few amnestic effects. However, all prescription drugs used as sleep aids may cause functional impairment, including “sleep driving,” defined as “driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event.”