What are the recommendations for a 65-year-old man who has been taking midazolam at doses of 15–30 mg three times a week for 30 years?

Taking midazolam at such high doses (the standard sleep dose is usually 7.5–15 mg) for three decades brings specific health challenges, especially with your active lifestyle.

Midazolam severely impairs motor coordination, reaction time, and muscle tone, which also persists the next day after ingestion. When working with horses and operating machines, this significantly increases the risk of falls, injuries and unforeseen accidents.

In people over 60 years of age, the metabolism of drugs in the liver slows down. This means that the drug accumulates in the body more strongly than before, which can lead to memory disorders, confusion and the so-called "hangover effect".

30 years of use suggests the development of a strong tolerance (the need for high doses for the effect) and physical dependence. Taking the drug "only" three times a week may cause you to experience so-called withdrawal symptoms on non-dose days (anxiety, tremors, rebound insomnia).

Long-term use of benzodiazepines is associated with an increased risk of premature cognitive impairment. With your year (1961), the protection of brain efficiency should be a priority.

In this situation, I advise against trying to suddenly discontinue the drug on your own, as it can be dangerous to your health with such an internship. I suggest consulting your doctor to develop a plan to go very slowly off the dosage or switch to a longer-acting drug that is easier to discontinue.

If you need more personalized advice, you can use the teleconsultation here:

https://www.gdziepolek.pl/telekonsultacja/

The advice is held in Polish.

I attach links to information that may be helpful:

https://www.gdziepolek.pl/artykuly/skuteczne-sposoby-na-stres

https://www.gdziepolek.pl/artykuly/bezsennosc