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[Benzodiazepine dependence: causalities and treatment options]
A Heberlein1, S Bleich, J Kornhuber
1Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Erlangen, Germany. annemarie.heberlein@uk-erlangen.de
Fortschritte Der Neurologie-Psychiatrie
|December 23, 2008
Summary
Benzodiazepine dependence can lead to withdrawal symptoms and addiction. Treatments using anticonvulsants and antidepressants may ease benzodiazepine withdrawal and improve long-term outcomes.
Area of Science:
- Neuroscience
- Pharmacology
Context:
- Benzodiazepines are widely prescribed for anxiolytic, sedative, and hypnotic effects.
- Long-term use frequently leads to physical dependence and withdrawal syndromes.
- Behavioral addiction to benzodiazepines is also a recognized issue.
Purpose:
- To explore the neural mechanisms underlying benzodiazepine dependence.
- To understand the role of GABAergic and glutamatergic neurotransmission.
- To investigate the involvement of neuropeptides in dependence.
Summary:
- Benzodiazepines enhance GABAergic neurotransmission, leading to counter-regulatory increases in glutamatergic neurotransmission during withdrawal.
- Altered expression of neuropeptides, such as Corticotropin Releasing Hormone and Neuropeptide Y, is implicated in dependence.
- Despite long-term use, even at low doses, adverse effects like cognitive dysfunction necessitate withdrawal.
Impact:
- Withdrawal from benzodiazepines is recommended due to adverse effects.
- Anticonvulsants and antidepressants show promise in mitigating withdrawal severity.
- These adjunct therapies may improve the long-term prognosis for individuals with benzodiazepine dependence.
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