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[Benzodiazepine--practice and problems of its use].
P J Meier1, W H Ziegler, K Neftel
1Departement für Innere Medizin, Universitätsspital, Zürich.
Schweizerische Medizinische Wochenschrift
|March 19, 1988
Summary
Benzodiazepines are widely prescribed but can lead to dependence, with 30-45% of long-term users experiencing withdrawal symptoms. To prevent benzodiazepine dependence, clinicians should limit prescriptions and restrict use to 7-14 days.
Area of Science:
- Pharmacology
- Neuroscience
- Clinical Pharmacy
Context:
- Benzodiazepines are frequently prescribed globally, with 3% of Swiss adults using them regularly for anxiety or sleep.
- These drugs activate central GABAergic neuroinhibition, producing anxiolytic, sedative, anticonvulsant, and muscle relaxant effects.
Purpose:
- To explore the pharmacokinetic and pharmacodynamic variations among benzodiazepine derivatives.
- To elucidate how these differences impact therapeutic outcomes and adverse reactions, including dependence and withdrawal.
Summary:
- Benzodiazepine derivatives exhibit diverse physicochemical and pharmacokinetic profiles, influencing their clinical utility.
- Elimination half-life is a key factor in adverse reactions like hangover, rebound insomnia, tolerance, and dependence.
- Low-dose benzodiazepine dependence affects 30-45% of chronic users, characterized by withdrawal symptoms upon cessation.
Impact:
- Optimizing benzodiazepine therapy requires considering individual drug properties to tailor treatment.
- Preventing benzodiazepine dependence is paramount due to the difficulty in managing withdrawal states.
- Recommendations include reduced prescribing and limiting use to short durations (7-14 days) to mitigate dependence risks.