Benzodiazepines require special precaution if used in the alcohol or drug dependent individuals and individuals with comorbid psychiatric disorders. It has been recommended that caution should be exercised in prescribing nitrazepam to anyone who is of working age due to the significant impairment of psychomotor skills; This impairment is greater the higher the dosage that is prescribed.
Nitrazepam in doses of 5 mg or more causes significant deterioration in vigilance performance combined with increased feelings of sleepiness.
Nitrazepam at doses of 5 mg or higher impairs driving skills and nitrazepam, like other hypnotic drugs is associated with an increased risk of road traffic accidents. In the elderly nitrazepam is associated with an increased risk of falls and hip fractures due to impairments on body balance. The elimination half-life of nitrazepam is 40 hours in the elderly and 29 hours in younger adults. Nitrazepam is commonly taken in overdose by drug abusers or suicidal individuals, sometimes leading to death. Nitrazepam is teratogenic if taken in overdose during pregnancy with 30 percent of births showing congenital abnormalities. Nitrazepam is a popular drug of abuse in countries where it is available.
Doses as low as 5 mg of nitrazepam can impair driving skills. Therefore people driving or conducting activities which require vigilance should exercise caution in using nitrazepam or possibly avoid it all together.
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