Anxiolytic drugs: dependence, addiction and abuse

  title={Anxiolytic drugs: dependence, addiction and abuse},
  author={Malcolm Harold Lader},
  journal={European Neuropsychopharmacology},
  • M. Lader
  • Published 1 June 1994
  • Psychology, Medicine
  • European Neuropsychopharmacology
Use of anticonvulsants in benzodiazepine withdrawal.
  • K. Pages, R. Ries
  • Medicine, Psychology
    The American journal on addictions
  • 1998
The authors review the typical syndrome associated with withdrawal from Benzodiazepines and discuss treatment of benzodiazepine withdrawal using carbamazepine and valproate to facilitate further treatment of their psychiatric or substance use disorder.
Addiction on prescribed sedative‐hypnotics
This paper reviews the conceptualization of addiction on prescribed sedative‐hypnotics medications; its evolution, occurrence, characteristics and validity. Such addictive behaviour is often
Physical dependence after benzodiazepine treatments in rats: Comparison of short and long treatments with diazepam and lorazepam.
The time-dependent change in the hexobarbital concentrations in the brain suggests that withdrawal excitation after diazepam treatment is a complex phenomenon probably involving several different systems at different times.
Cannabinoids in health and disease
The development of more selective cannabinoid receptor agonists/antagonists and related compounds, as well as on novel drugs of this family with better selectivity, distribution patterns, and pharmacokinetics, are needed - in cases where it is impossible to separate the desired clinical action and the psychoactivity - just to monitor these side effects carefully.
Abuse liability of flunitrazepam.
Experimental studies of animals and normal human subjects indicate that, although flunitrazepam has high efficacy and is very potent, it is pharmacologically similar to most other benzodiazepines.
Is there a lamotrigine withdrawal syndrome?
A patient who developed a psychomotor inhibition state after a rapid cessation of lamotrigine (LTG) was considered as having a withdrawal reaction to LTG which was confirmed by spontaneous resolution after a few days.
Drugs as instruments: A new framework for non-addictive psychoactive drug use
It is argued that drug instrumentalization behavior may provide a functional adaptation to modern environments based on a historical selection for learning mechanisms that allow the dynamic modification of consummatory behavior.
Hypersusceptibility to DMCM-induced seizures during diazepam withdrawal in mice: evidence for upregulation of NMDA receptors
The behavioral experiments suggest that NMDA receptor antagonists may suppress benzodiazepine withdrawal responses, while the biochemical study reveals upregulation of theNMDA receptor, which may play an important role in the hypersusceptibility to DMCM-induced seizure in diazepam-withdrawn mice.


A pilot study of the effects of flumazenil on symptoms persisting after benzodiazepine withdrawal
The benefits last between a few hours and several days despite flumazenil's otherwise short duration of action, however, symptoms did return to varying degrees in most cases, suggesting the need for repeated doses.
Patterns of benzodiazepine abuse and dependence.
Two groups of subjects emerged: patients who used only benzodiazepines for long periods of time and those who used Benzodiazepine in the context of multiple drug abuse, where Diazepam was most frequently alleged in both groups, but relative preference for other benzodiazines differed.
The prolonged benzodiazepine withdrawal syndrome: anxiety or hysteria?
It was concluded that PWS is likely to be a genuine iatrogenic condition, a complication of long‐term benzodiazepine treatment.
Benzodiazepine withdrawal phenomena.
The withdrawal syndrome subsided after 2 weeks and was similar in both groups of patients and EEG changes were detected on withdrawal opposite to those known to be associated with initiation of diazepam treatment.
Biological processes in benzodiazepine dependence.
  • M. Lader
  • Psychology, Biology
  • 1994
The molecular pharmacology of the benzodiazepine-GABA-chloride receptor is complex, with a wide range of different subunits and various clinical implications are explored, including the use of flumazenil to prevent and to treat Benzodiazepines withdrawal syndromes.
Comparison of diazepam and oxazepam: preference, liking and extent of abuse.
Previous experimental observations suggesting that diazepam has a higher abuse liability than oxazepam are extended, compatible with an analysis of epidemiological data showing thatdiazepam abuse uniformly exceeds oxzepam abuse on seven epidemiological measures of drug abuse.
Long-term treatment of anxiety and risk of withdrawal. Prospective comparison of clorazepate and buspirone.
There was a significant increase in symptom severity consistent with a withdrawal reaction for the clorazepate group but not the buspirone group, and there was a suggestion that previous discontinuous exposure to benzodiazepines might sensitize patients to subsequent withdrawal effects.
The practical business of treatment. XVII, Benzodiazepine problems
Patients with apparent benzodiazepine dependence need careful assessment with respect to personality, social situation and psychiatric disorder and must be motivated and carefully prepared for withdrawal and taught anxiety management techniques.