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Management of benzodiazepine misuse and dependence PMC

In 2018, between 8.3% and 12.8% of BZD users in Switzerland have prescriptions from multiple physicians which resulted in the inability to track the number of prescriptions a patient is given yearly [40]. In a survey of British general practitioners, many reported pressures in prescribing BZD to patients and a lack of adequate knowledge on alternative psychological treatment for insomnia [41]. provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.

  • This allows chloride ions to enter the neuron cells, which results in CNS depression.
  • These patients are more likely to die from methadone toxicity because of the synergistic effects of methadone and BZD [68].
  • Current studies are aimed to decrease this rebound anxiety effect while also decreasing relapse into BZD use using different medications, counseling, BZD dosing strategies, or different tapering techniques.
  • Withdrawal, like with alcohol since they exert their effects on similar receptors, can be life threatening.

Respondents were not asked if they were taking or tapering from other sedating or non-benzodiazepine hypnotic drugs. No questions were asked that might have allowed baseline symptoms to be compared with symptoms at other points in the trajectory of benzodiazepine use. BIND serves as a clinically serviceable name for the enduring neurological sequelae of benzodiazepine use and would reify this condition for healthcare professionals. Patients in our survey sometimes wrote in comments that they felt like healthcare professionals did not take them seriously or frankly challenged or disbelieved their long-lasting symptoms [9]. Recognizing this condition with a specific medically accepted term may encourage more professional compassion, better treatment, and future research.

1. Indications for Benzodiazepines

Their sedative effect aids in sleep and insomnia disorders by reducing sleep onset latency. Their CNS depressant effects potently reduce anxiety and abort acute-onset panic and anxiety attacks [4]. Benzodiazepines are also incredibly effective at rapidly aborting convulsant activity in those with epilepsy or other seizure disorders [5]. Systems limitations in prescription monitoring in Australia reduce our ability to identify ‘doctor shopping’ so the presence of any aberrant drug-related behaviours should prompt further assessment and treatment. Any patient who has taken a benzodiazepine for longer than 3–4 weeks is likely to have withdrawal symptoms if the drug is ceased abruptly.

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BZDs were encouraged for anyone wanting to calm their nerves and ease their sleep, causing them to rapidly attain favor in society [6]. Additionally, given the continual rise of anxiety and sleep-disordered problems over the decades, BZDs remain a regular fixture in the United States today [7]. However, with this ongoing, widespread use comes the dark reality of BZD dependence [6].

Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey

The difference in these characteristics dictates the clinical applicability of the drugs. Oxazepam, temazepam, and chlordiazepoxide which are low potency benzodiazepines are well tolerated with low toxicity levels. Alprazolam, lorazepam and clonazepam are high potently clinically used to treat panic disorders and serve as adjuncts for treating many other diseases [1]. Due to their toxic effect on the central nervous system, appropriate care is necessary with BZD. BZDs lead to long-lasting impairment of episodic implicit memory while it only impairs implicit memory transiently [1].

Respondents to the survey might have been taking their full dose of benzodiazepines, engaged in the process of tapering off benzodiazepines, or had fully discontinued benzodiazepines. Respondents were asked to select among 23 symptoms they may have experienced and to indicate the duration of each symptom (see S1 Appendix). Of all respondents, 88.1% reported having anxiety, nervousness, or fear; 86.9% sleep disturbances; 86.2% low energy levels; and 85.3% difficulty focusing or distractedness. Some respondents reported these symptoms occurring following complete cessation of benzodiazepines and for long-term durations of months or years. In fact, 76.6% of all affirmative answers on symptom questions reported symptom durations to be months or “one year or longer.” The most frequently reported symptoms lasting one year or more appear in Table 1.

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