Use of benzodiazepines in psychiatric in-patients

Various anxiety states and states of panic are the classical indications for the use of benzodiazepines in hospital treatment. The clinician must distinguish the cases where a depressive or schizophrenic symptom formation underlies the panic or anxiety; in such cases antidepressants and neuroleptics yield the best results. Delirium tremens is still a serious illness. In order to calm down the patients sufficiently, appropriate sedative medication is necessary, along with other forms of general treatment. Though adequate alternatives have also been recommended, benzodiazepine therapy must at present be considered one of the most efficient and best forms of drug therapy in delirium tremens. It must be stressed that the dosage should be prescribed individually. When long-acting benzodiazepines are used, the dosage should be reduced daily by 25% of the initial dose. Benzodiazepine derivatives may be used as hypnotics in cases where the patient's ability to sleep is considered important for his treatment. Short-acting preparations of the benzodiazepine group can usually be recommended, unless particular reasons indicate the use of long-acting ones. The possibilities and limitations of combining benzodiazepines with neuroleptics and antidepressants in the treatment of schizophrenic and depressive patients are also discussed.