Beginning with chlordiazepoxide in 1960, benzodiazepines havebeen used extensively for the treatment of anxiety and relateddisorders. Eight benzodiazepine derivatives have been approvedby the Food and Drug Administration for this purpose (Table 1).Another benzodiazepine, clonazepam, is also prescribed forthis purpose but is labeled as an anticonvulsant.
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Table 1. Benzodiazepine Anxiolytic Agents.
The clinical, pharmacokinetic, and neurochemical propertiesof the benzodiazepine derivatives have been the focus of manyarticles in the scientific literature1,2,3,4,5,6. Much is knownabout their molecular mechanisms of action, properties of distributionand elimination, clinical activity, and side effects. Like manyother classes . . . [Full Text of this Article]
The Target Disorders
Clinical Features
Prevalence and Consequences
Pharmacologic Treatment
Approach to the Pharmacologic Treatment of Anxiety
The Decision to Treat
Choice of Specific Medication
Initiation and Maintenance of Treatment
Side Effects of Benzodiazepines
Predictable, Common Side Effects
Paradoxical Effects
Tolerance, Abuse, Dependence, and Discontinuation
Tolerance
Abuse
Dependence
Discontinuation of Benzodiazepines
Recurrence
Rebound
Withdrawal
Discontinuation of Benzodiazepines with Short Half-Lives
The Persistent Benzodiazepine Discontinuation Syndrome
Conclusions
Source Information
From the Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, and the Division of Clinical Pharmacology, New England Medical Center Hospital, Boston.
Address reprint requests to Dr. Shader at the Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111.
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