Current benzodiazepine issues

  title={Current benzodiazepine issues},
  author={James H. Woods and Gail D. Winger},
This article deals with some of the recent evidence bearing on the issues of the liability of benzodiazepines to lead to abuse, dependence, and adverse behavioral effects. Reviews of epidemiological, clinical and experimental literature indicated that the previous conclusion about abuse of these drugs still holds: the vast majority of the use of benzodiazepines is appropriate. Problems of nonmedical use arise nearly exclusively among people who abuse other drugs. Nevertheless, there are reasons… 

Withdrawing Benzodiazepines in Primary Care

The clearest strategy was to taper the medication; abrupt cessation can only be justified if a very serious adverse effect supervenes during treatment, and no clear evidence suggests the optimum rate of tapering, and schedules vary from 4 weeks to several years.

The role of benzodiazepines in treating social anxiety disorder.

  • E. Silberman
  • Psychology, Medicine
    The American journal of psychiatry
  • 2014
Long-term controlled trials of benzodiazepine monotherapy, including monitoring of efficacy, tolerability, and abuse in the treatment of social and other anxiety disorders, may be difficult to fund, but would be a great service to patients who suffer from these often undertreated conditions.

Benzodiazepines: more "behavioural" addiction than dependence

The distribution of dose and length of treatment shows no evidence of pharmacological tolerance, neither in the whole sample nor in those patients with addiction (SDS+), reinforcing the idea that psychological dependence (addiction) is more relevant than pharmacological or physiological dependence in benzodiazepine chronic use.

Lack of relationship between long-term use of benzodiazepines and escalation to high dosages.

The results of this study did not support the hypothesis that long-term use of benzodiazepines frequently results in notable dose escalation, and no clinically or statistically significant changes in dosage were observed over time.

Addiction to Benzodiazepines

  • C. Salzman
  • Psychology, Medicine
    Psychiatric Quarterly
  • 2004
It is unclear whether there are meaningful differences among benzodiazepines in producing a state of dependence, but Benzodiazepine dependence is also characterized by a predictable discontinuation syndrome.

Abuse and Dependence Liability of GABAA-Receptor Modulators

Perhaps the most firm conclusion that can be made is that stimulation of GABAA receptors containing α1 subunits (α1GAB AA receptors) is not necessary for self-administration of benzodiazepine-type compounds, and systematic studies with selective compounds having relatively high intrinsic efficacy at particular subtypes should shed light on theses important mechanistic issues.

Nonmedical Abuse of Benzodiazepines in Opiate-Dependent Patients in Tehran, Iran

Nonmedical abuse of benzodiazepines is an important problem among opiate addicts which should be considered in treatment interventions during MMT program.


The results stress the need to take a more elaborate, person-centered view of dependence, and suggest six indicators of dependence.

A postmarketing study of relative abuse liability of hypnotic sedative drugs.

This pilot study suggests that postmarketing information on hypnotic drug use obtained from drug addicts entering treatment produces data consistent with other measures of abuse liability, and suggests that the risk of misuse of newer non-benzodiazepine hypnotics may be less than that of benzodiazepines, and similar to that of sedating antidepressants.

Pharmacokinetic Determinants of the Clinical Effects of Benzodiazepine Agonist Hypnotics

O Ongoing pharmaceutical research has the objective of developing drug delivery innovations that can optimize hypnotic drug action by regulation of release and systemic exposure to short half-life BZ agonists.



Use and abuse of benzodiazepines. Issues relevant to prescribing.

A comprehensive review of the extensive experimental, clinical, and epidemiologic literature pertinent to the use and abuse of benzodiazepines indicates that these two predominant routes of use are abuse and dependence.

Appropriate Use and Regulatory Control of Benzodiazepines

Attributable in part to this scientific and medical consensus, benzodiazepines largely replaced barbiturates and meprobamate as pharmacologic treatment for anxiety and sleep disorders.

Controlled discontinuation of benzodiazepine treatment for patients with panic disorder.

The findings indicate that withdrawal phenomena commonly occur after patients stop taking benzodiazepines and that they are more frequent after discontinuation of treatment with shorter-acting drugs.

Risk factors in the use of benzodiazepines.

Two factors that put the population at large at risk for using benzodiazepines are found; the family doctor's diagnosis of a mental disorder in the clinical history and the daily use of drugs other than Benzodiazepine explained the risk independently.

Benzodiazepine anti-anxiety agents: prevalence and correlates of use in a southern community.

Multivariate analyses of use patterns for the drugs indicate that when potential confounding factors are controlled, age, sex, race, education, and marital status are significantly related to benzodiazepine anxiolytic use but the effects of sex and education are mediated by intervening variables.

Prevalence and correlates of the long‐term regular use of anxiolytics

The data suggest that long-term regular users tend to be older persons with high levels of emotional distress and chronic somatic health problems, and many are sufficiently distressed to seek out other sources of help (mental health professionals and other psychotherapeutic medications).

Long-term therapeutic use of benzodiazepines. II. Effects of gradual taper.

Baseline personality, high Eysenck neuroticism, female sex, and mild-to-moderate alcohol use were found to be more significant predictors of withdrawal severity than the daily benzodiazepine dose or benzodiazine half-life.

Long-term therapeutic use of benzodiazepines. I. Effects of abrupt discontinuation.

A short half-life and higher daily doses were associated with greater withdrawal severity, as were personality traits, such as dependency and neuroticism, less education and higher baseline levels of anxious and depressive symptoms.

Resumption of benzodiazepine use after withdrawal in hospital--a follow-up study.

This study was intended to investigate how many patients would start to take benzodiazepines again after discharge and how far characteristics of the patients could prediet that resumption of Benzodiazepine use.