The abuse potential of benzodiazepines with special reference to oxazepam

Extensive use of oxazepam, particularly in the abuse-prone population of alcoholic patients, has shown that the dependence-producing potential of this drug is remarkably low, only four cases of dependence having been encountered over many years. Even abrupt withdrawal of oxazepam does not normally precipitate an abstinence syndrome. A computerized literature search retrieved 68 papers on benzodiazepine abuse and/or dependence, only 4 (6%) being concerned with oxazepam. Three reasons are proposed to account for the exceptionally low abuse-potential of oxazepam, the first being considered to be the most important: its onset of central nervous system activity is gradual, so there is no sudden 'intoxication' effect; it tends to cause dizziness at high dosages, discouraging the patient to increase the dose; and because it has a short half-life and no major active metabolites, intermittent therapy (which many patients now practise with all benzodiazepines), periodically allows the complete elimination of the drug from the body.