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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 when the higher dosages are prescribed.Nitrazepam, similar to other benzodiazepines and nonbenzodiazepines, causes impairments in body balance and standing steadiness in individuals who wake up at night or the next morning. Combination with alcohol increases these impairments. Partial but incomplete tolerance develops to these impairments.

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A geriatric unit reportedly was seeing as many as seven patients a month with nitrazepam-induced disabilities and health problems.

The drug was recommended to join the barbiturates in not being prescribed to the elderly.

Development, for example the ability to walk at five years of age, was impaired in many children taking nitrazepam, but was not impaired with several other nonbenzodiazepine antiepileptic agents.

Children being treated with nitrazepam have been recommended to be reviewed and have their nitrazepam gradually discontinued whenever appropriate.

The use of nitrazepam during pregnancy can lead to intoxication of the newborn.

A neonatal withdrawal syndrome can also occur if nitrazepam or other benzodiazepines are used during pregnancy with symptoms such as hyperexcitability, tremor, and gastrointestinal upset (diarrhea or vomiting) occurring.

Children treated with nitrazepam for epilepsies may develop tolerance within months of continued use, with dose escalation often occurring with prolonged use.

Sleepiness, deterioration in motor skills and ataxia were common side effects in children with tuberous sclerosis treated with nitrazepam.

The Dutch, British and French system called the System of Objectified Judgement Analysis for assessing whether drugs should be included in drug formularies based on clinical efficacy, adverse effects, pharmacokinetic properties, toxicity, and drug interactions was used to assess nitrazepam.

A Dutch analysis using the system found nitrazepam to be unsuitable in drug-prescribing formularies.

The side effects of nitrazepam may impair the development of motor and cognitive skills in children treated with nitrazepam.

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