Benzodiazepine use and abuse by patients at outpatient clinics

Article Abstract:

Benzodiazepines are a group of psychotropic drugs, including tranquilizers and hypnotics, which are commonly prescribed to alleviate anxiety or treat insomnia. Physical dependence may occur with prolonged use or high dosage, resulting in withdrawal symptoms such as severe psychosis and seizures. The abuse of and dependence upon benzodiazepines has been recognized as a problem in the US. A study of 2,719 outpatients who were given this drug was conducted and a sampling of data from a number of outpatient clinics, both psychiatric and non-psychiatric, was gathered. The data did not include patients that were being treated for alcohol abuse. Overall, the instance of benzodiazepine usage was low, ranging from two percent in the medical primary care clinic to 11 percent in the geriatric psychiatric clinic. Most of the patients were found to use the drug in low dosages. These results were measured against the DSM-III (Diagnostic and Statistical Manual of Mental Disorders, third edition) criteria for abuse and dependence. The DSM criteria for substance abuse and substance dependence are listed separately. Both categories concentrate upon social, psychological, occupational or physical aspects of drug taking, with dependency being more concerned with factors such as increased tolerance and quantity. None of these patients fell into the category of abusers or were classified as dependent upon benzodiazepine according to these guidelines. The results corroborate a similar study of comparable facilities which was conducted in Austria. It was concluded that the treatment of outpatients with benzodiazepines does not promote dependency or contribute to the drug abuse problem. However, the results of the study were limited by the fact that there was no direct evaluation of any patient. Therefore, symptoms of abuse or dependence may have gone unnoticed and unrecorded.

Research, Tranquilizing drugs, Tranquilizing agents, Benzodiazepine abuse

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The APA task force report on benzodiazepine dependence, toxicity, and abuse

Article Abstract:

Benzodiazepines are central nervous system depressants commonly prescribed for the short-term treatment of anxiety, stress or insomnia. The American Psychiatric Association in 1987 formed a task force to assess their therapeutic effects. They found that although therapeutic use is usually limited to 60 days or less, a substantial number of adults (1.65 percent of the population) have been taking benzodiazepines for one or more years. Short-term treatment with standard therapeutic doses rarely proves harmful. However, high doses or prolonged periods of use can result in toxicity or dependence, particularly among people who also abuse alcohol, opiates, cocaine or other sedatives. Dependence is also more likely to occur among individuals with a past history of alcoholism. Elderly patients are particularly sensitive to benzodiazepine toxicity, which can lead to confusion, unsteadiness and falling down. Physical benzodiazepine dependence is defined by three categories of discontinuation symptoms. Rebound symptoms are the first to appear and include intense anxiety, insomnia and restlessness. Recurrence symptoms usually follow rebound, and tend to mimic the symptoms for which the drug was originally prescribed. Withdrawal symptoms, which can include seizures and psychotic episodes, usually occur only after prolonged treatment with high doses. When a system of slow tapering off rather than abrupt discontinuance is employed, all three symptoms are greatly reduced. Although benzodiazepines are useful and important therapeutic drugs when carefully prescribed and monitored, potential risks must be carefully considered by both physicians and patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Drug therapy, Anxiety, Drug withdrawal symptoms, Substance withdrawal syndrome, editorial

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Benzodiazepine dependence and withdrawal in elderly patients

Article Abstract:

The study compared the severity of withdrawal from benzodiazepines, a group of mild tranquilizers in 19 elderly and 22 younger benzodiazepine-dependent patients. As the dosage of tranquilizers dropped, the elderly patients showed significantly less severe withdrawal symptoms and had a comparably favorable outcome. Approximately half of each group did not receive benzodiazepines for at least one month. Neither group suffered from serious withdrawal symptoms such as seizures or psychosis. Elderly patients did not seem to be at higher risk than younger patients from gradual withdrawal from benzodiazepines. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aged, Elderly, Drug use

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