DR Medhat MRCP

Benzodiazepines
- Benzodiazepines enhance the effect of the inhibitory neurotransmitter gammaaminobutyric
acid (GABA) by increasing the frequency of chloride channels.
• Uses :
They are used for a variety of purposes:
Sedation
Hypnotic
Anxiolytic
Anticonvulsant
Muscle relaxant
- Patients commonly develop a tolerance and dependence to benzodiazepines and
care should therefore be exercised on prescribing these drugs.
- The Committee on Safety of Medicines advises that benzodiazepines are only
prescribed for a short period of time (2-4 weeks).
• Adverse effects :
1. Drowsiness 2. Dizziness
3. Decrease alertness & concentration 4. Depression of resp. center & BP if taken IV.
• Withdrawal :
- The BNF gives advice that the dose should be withdrawn in steps of about 1/8 (range
1/10 to 1/4) of the daily dose every fortnight.
- A suggested protocol for patients experiencing difficulty is given:
Switch patients to the equivalent dose of diazepam.
Reduce dose of diazepam every 2-3 weeks in steps of 2 or 2.5 mg
Time needed for withdrawal can vary from 4 weeks to a year or more
• Features of quick benzodiazepine withdrawal :
- This may occur up to 3 weeks after stopping a long-acting drug.
Insomnia
Irritability
Anxiety
Tremor
Loss of appetite
Tinnitus
Perspiration
Perceptual disturbances
Seizures
سؤال syndrome. Hypothermia is not a feature of benzodiazepine withdrawal
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