Benzodiazepine Use Disorder: Common Questions and Answers
In addition to the risks to the individual, there is also risk for greater drug diversion and exposure of these medications to grandkids if not properly stored and disposed.” Other studies have assessed different methods of counseling on BZD dangers and alternatives to patients alongside a gradual taper off the drugs. One study compared the mainstay of treatment medication for the treatment of alcohol use disorder with a standardized interview/counselling approach to treatment [72]. The experimental group in this study had a weekly 1/10-dose reduction after a 2 week stabilization period [72]. The experimental treatment also included a BZD diary, a drinking diary, BZD withdrawal education, and assessments for ways of coping and “progressive relaxation exercise” [72].
- Indeed, severe withdrawal symptoms, including seizures, were observed in PD patients following drug discontinuation with BZ and AD [16, 17].
- Some studies in the past have shown that there is a correlation between chronic BZD use and a decline in cognitive function, including the development of dementia and dementia-like diseases.
- The present study provides important insight regarding the prescription patterns of BZD in outpatients with PSD amplified with clinically relevant information.
With the large sample size in this study, very small differences can be statistically significant but not clinically meaningful (26). Therefore, we focused on relative differences of 10% or more as clinically meaningful (27, 28). Many benzodiazepines are only prescribed in the short-term to treat anxiety disorders, panic disorders, and symptoms of alcohol withdrawal. Official labels for benzos like Xanax, Librium, and Valium warn physicians to make benzodiazepine prescriptions short-term. Cognitive behavioral therapy (CBT) is a form of talking therapy aimed at changing the way a person thinks and behaves, to help reduce symptoms of various mental health conditions, including anxiety disorders. Many medications have been tested to alleviate withdrawal symptoms and make it easier for patients to discontinue BZD since a gradual taper does not always lead to successful discontinuation of the drug.
4. Long-Term Effects of Benzodiazepine Use
Due to its short half-life, and rapid absorption, alprazolam is distinguished as one of the most rapid-acting BZD with fastest relief of symptomology, increasing its abuse liability [54]. Alprazolam is widely used as monotherapy for panic disorder and anxiety and was found superior to other forms of monotherapy for these conditions including other BZD, non-SSRI antidepressants, and buspirone. This superior effect is thought to be due to its unique alpha-2 adrenergic activity, enhancing its potency for relieving panic and anxiety disorders. This same mechanism is also thought to be the cause behind alprazolam’s strong rebound hyperadrenergic effects with cessation [54,55]. Many drug therapies have been suggested as treatment for alprazolam withdrawal with few rendered effective.
Effect on sleep
To be specific in terms of binding sites and actions, BZD binds between the alpha and the gamma subunit. It enhances the effect of GABA at the GABA-A receptor, allowing it to exert a more significant effect [2]. A Cochrane review found that a combination of antidepressants and benzodiazepines was more effective than antidepressants alone mental health and substance abuse health coverage options in improving depression early, but this effect was not sustained (37). Because of the potential for people to become dependent on benzodiazepines, longer-term studies are needed to examine combined benzodiazepine and antidepressant treatment that involves withdrawing the benzodiazepine after a short period, such as 1 month (37).
Institutional Review Board Statement
The present study provides important insight regarding the prescription patterns of BZD in outpatients with PSD amplified with clinically relevant information. Long-term BZD prescription could be considered as a therapeutic strategy targeted toward patients with more severe forms of PSD in outpatient practice; however, that is not supported by guidelines. Our results could also suggest a link between BZD-LT prescription and disabling adverse effects, particularly related to cognitive functioning. Because we noticed that patients who are BZD-LT users have higher levels of reality distortion symptoms, it could be that instead of increasing daily dose of APs, clinicians were more prone to add and continue with BZD to prevent complications and achieve control of the agitation.
Some new BZDR users may have previously used BZDRs before the BZDR-free period of 2 years. Although a range of comorbid conditions was derived from registers, these data sources have inherent limitations. Register-based data do not indicate whether dispensed drugs have actually been used49; this, however, may be a lesser problem than recreational use. The Care Register for Health Care data were based on inpatient care only, and thus, diagnoses may have represented only the most severe cases. For many diagnoses, data from the special reimbursement register were also used, and the register also provides diagnoses from primary care. However, register-based data lack information on severity of diseases and symptoms as well as, for example, smoking, alcohol use, and nutrition, and consequent residual confounding may still exist.
