Benzodiazepines anxiolytics

As anxiolytics, benzodiazepines have faster onset of effect than SSRIs or antipsychotics. Their use is best limited to short-term situations, although there are likely to be comparable risks of dependence in these populations from all major classes of drugs. 

Insomnia is a common comorbid condition with depression, and frequently is made worse by antidepressants, particularly the SSRIs. When insomnia persists despite adequate evaluation and attempts to reduce it by other approaches, it is often necessary to use a concomitant sedative-hypnotic, especially a short-acting nonbenzodiazepine with rapid onset such as zaleplon or zolpidem. At times a benzodiazepine sedative hypnotic such as triazolam or temazepam may be necessary. If anxiety persists during the day and cannot be otherwise managed, it may be necessary to add an anxiolytic benzodiazepine such as alprazolam or clonazepam. Use of sedative-hypnotics and anxiolytics should be short-term whenever possible. 

OFFICIAL NAMES Minor tranquilizers (sedative-hyp-notics/anxiolytics)/Benzodiazepines Alprazolam (Xanax) chlordiazepoxide (Librium, Novopoxide) clonazepam (Klonopin) clorazepate (Azene, Tranxene) diazepam (Valium) estazolam (ProSom) flunitrazepam (Rohypnol/illegal in the United States) flurazepam (Dalmane) halazepam (Paxipam) lorazepam (Ativan) midazolam (Versed) oxazepam (Serax) prazepam (Centrax) quazepam (Doral) temazepam (Restoril) triazolam (Halcion)... 

Hindmarch I, Haller J, Sherwood N, Kerr JS (1990) Comparison of five anxiolytic benzodiazepines on measures of psychomotor performance and sleep. Neuropsychobiology 24 84-89... 

Female orgasm is inhibited by some central depressant and psychotropic drugs, including neuroleptic drugs, antidepressants, and anxiolytic benzodiazepines (204). 

Figure 9.2. Metabolic pathways for common anxiolytic benzodiazepines. Capitalized names are marketed drugs. Active metabolite.

About 6000 chemical entities can be used, in various pharmaceutical formulations, to treat human or animal diseases all attempts towards their classification represent arbitrary procedures. The first reason for that is that not a single drag has ever been encountered which exhibits only one biological activity. The antimalarial drug chloroquine is also active on some inflammatory processes, the anxiolytic benzodiazepines possess antiepileptic properties, etc. On the other hand, the scientific communities have different needs a chemical classification may sometimes be very useful to medicinal chemists but strictly of no interest to a social security employee. Conversely pharmacologists and physicians will probably prefer the physiological classification. 

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