Meprobamate in older adults is discouraged due to:

• A. High rate of physical dependence and very sedating effects.
• B. Safest choice for older adults with sleep issues.
• C. Minimal risk of dependence.
• D. Effective for anxiety with no sedation.

Answer: (A)

Meprobamate is avoided in older adults because it provides strong CNS depression and has a high potential for physical dependence, to which the elderly are especially susceptible. Its sedating effects can lead to daytime drowsiness, confusion, dizziness, and impaired balance, increasing the risk of falls and cognitive impairment. Age-related changes in metabolism and clearance mean the drug can accumulate, prolonging its effects and worsening delirium or sedation. These factors make it far less safe than alternative treatments for sleep or anxiety in older people, where the notions of minimal dependence risk or no sedation do not apply.