Anxiety caused by a short-life hypnotic

  title={Anxiety caused by a short-life hypnotic},
  author={Anthony N. Nicholson and A. J. Belyavin and Barbara M. Stone and Mick B Spencer},
  journal={British Medical Journal (Clinical research ed.)},
  pages={215 - 215}
reports four deaths in 30 years attributed to milk-related infection as against a yearly toll of 150 000 deaths from coronary disease in England and Wales. The evidence which began to accumulate in the last 15 or so years about the possible connection between coronary disease and milk consumption comes from several independent studies: epidemiological, immunological, experimental, and clinical. Virtually every plant we eat-cereals, potatoes, carrots, onions, pulses, tomatoescontains substances… 
Benzodiazepines on trial.
  • P. Tyrer
  • Psychology, Medicine
    British medical journal
  • 1984
Ashton's careful study is the latest of several investigations that have shown quite unequivocally that benzodiazepines may produce pharmacological dependence in therapeutic dosage, and stems from the early symptoms of withdrawal being those of anxiety, so that when a patient becomes anxious after withdrawal of benzdiazepines this may be mistaken simply for a return of pre-existing anxiety.
Benzodiazepine Dependence
The withdrawal syndrome is characterised by withdrawal symptoms on stopping treatment; these include perceptual disturbances, epileptic seizures, weight loss, insomnia and autonomic symptoms, and can best be avoided by gradual reduction of dosage.
The clinical use of hypnotics: indications for use and the need for a variety of hypnotics
  • K. Rickels
  • Psychology, Medicine
    Acta psychiatrica Scandinavica. Supplementum
  • 1986
Clinicians in general tend to use long half‐life benzodiazepine hypnotics in patients who have difficulties maintaining sleep and short half-life Benzodiazepines for treating sleep onset insomnia.
Commentary 1
2. Pakes GE, Brogden RN, Heel RC et al. Triazolam: a review of its pharmacological properties and therapeutic efficacy in patients with insomnia. Drugs 1981 ;22:81-110. 3. Eberts FS, Philopoulos Y,
Midazolam: The First Water‐soluble Benzodiazepine; Pharmacology, Pharmacokinetics and Efficacy in Insomnia and Anesthesia
  • J. Kanto
  • Biology, Medicine
  • 1985
In major surgery, midazolam is an alternative to thiopental for induction of anesthesia in spite of its slow, variable induction time, and its advantages include good cardiovascular stability, transient and mild respiratory depression, low frequency of venous irritation, production of anterograde amnesia and short duration of action in comparison with other benzodiazepines.
Guidelines for the rational use of benzodiazepines. When and what to use.
Indications for benzodiazepines include acute stress reactions, episodic anxiety, fluctuations in generalised anxiety, and as initial treatment for severe panic and agoraphobia, and occasionally in acute psychoses.
Pharmacology and Hypnotic Efficacy of Triazolam
Overall, triazolam is an effective and safe compound for the symptomatic treatment of insomnia complaints, making it the shortest acting benzodiazepine available in the United States.
Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications
The present overview aimed at analyzing the literature to illustrate withdrawal after decrease, discontinuation, or switch of psychotropic medications based on the drug class, finding that benzodiazepines should be substituted by medications that cause less dependence such as antidepressants and antipsychotics runs counter the available literature.
Quazepam: Hypnotic Efficacy and Side Effects
  • A. Kales
  • Medicine, Psychology
  • 1990
Quazepam is a benzodiazepine hypnotic that can be useful in the adjunctive pharmacologic treatment of insomnia and is more effective with short‐term use, and with continued use it maintains its efficacy in contrast to both of these drugs which show rapid development of tolerance.
Commentary 4
Testimonial experience in this institution has identified no problems with the use of temazepam in the elderly, but flurzepam produces daytime drowsiness in occasional patients, and the short half-life of triazolam would appear to be an advantage in this population, but it is felt that the effects on cognitive performance outweigh the pharmacokinetic advantages, and it is hesitant to initiate trizolam therapy in these patients.