Benzodiazepin treatment

Ciraulo DA, Jaffe JH Tricyclic antidepressants in the treatment of depression associated with alcoholism. Clin Psychopharmacol 1 146—150, 1981 Ciraulo DA, Nace E Benzodiazepine treatment of anxiety or insomnia in substance abuse patients. Am J Addict 9 276—284, 2000 Ciraulo DA, Barnhill JG, Jaffe JH, et al Intravenous pharmacokinetics of 2-hydroxy-imipramine in alcoholics and normal controls. J StudAlcohol 51 366-372, 1990 Ciraulo DA, Knapp CM, LoCastro J, et al A benzodiazepine mood effect scale reliability and validity determined for alcohol-dependent subjects and adults with a parental history of alcoholism. Am J Drug Alcohol Abuse 27 339—347, 2001 Collins MA Tetrahydropapaveroline in Parkinson s disease and alcoholism a look back in honor of Merton Sandler. Neurotoxicology 25 117-120, 2004 COMBINE Study Research Group Testing combined pharmacotherapies and behavioral interventions in alcohol dependence rationale and methods. Alcohol Clin Exp Res 27 1107-1122, 2003a... 

Ciraulo DA, Nace EP Benzodiazepine treatment of anxiety or insomnia in substance abuse patients. Am J Addict 9 276—284, 2000 Ciraulo DA, Barnhill JG, Greenblatt DJ, et al Abuse liability and clinical pharmacokinetics of alprazolam in alcoholic men. J Clin Psychiatry 49 333—337, 1988a... 

Otto MW, Pollack MH, Sachs GS, et al Discontinuation of benzodiazepine treatment efficacy of cognitive-behavioral therapy for patients with panic disorder. Am J... 

Petursson H, Lader MH Benzodiazepine dependence. BrJ Addict 76 133—143,1981a Petursson H, Lader MH Withdrawal from long-term benzodiazepine treatment. Br Med J (Clin Res Ed) 283 643—643, 1981b Pichard L, Gillet G, Bonfils C, et al Oxidative metabolism of zolpidem by human liver... 

Benzodiazepines are recommended for acute treatment of GAD when short-term relief is needed, as an adjunct during initiation of antidepressant therapy, or to improve sleep.25,26 Benzodiazepine treatment results in a significant improvement in 65% to 75% of GAD patients, with most of the... 

When initiating benzodiazepine treatment for GAD, tolerability can be improved by starting at a low dose and gradually titrating to the effective dose range over the course of several days. Most patients with GAD respond well to l-3mg/day of extended-release alprazolam, l-2mg/day of clonazepam, or 10-20mg/day of diazepam. Elderly patients often do best at approximately half these daily doses. 

First-line GAD treatments include (1) cognitive-behavioral therapy (CBT), (2) antidepressants, (3) buspirone, and (4) benzodiazepines. Treatment selection is determined by the severity of the illness, the presence of any comorbid illnesses, previous patient treatment responses, and patient preference. When treating mild GAD, we recommend eschewing psychotropic medication altogether in favor of CBT. Moderate-to-severe GAD usually requires pharmacotherapy, though combined CBT-pharmacotherapy is highly encouraged. 

Antidepressants are as effective as benzodiazepines in the treatment of panic disorder. Moreover, antidepressants do not have the same risks of tolerance and dependency that are associated with benzodiazepine treatment. However, antidepressants take longer to work, so that significant improvement might not be observed until after a month of treatment. Although tricyclic antidepressants have been approved for the treatment of panic disorder, the effectiveness of selective serotonin reuptake inhibitors (SSRIs) in its treatment has led them to become the favored treatment among antidepressant drugs. 

Figure 1.4 The chemical structure of alprazolam (Xanax) categorizes the drug as a benzodiazepine. Treatment with benzodiazepine is recommended for patients with panic disorder. Xanax can be habit-forming and treatment should be closely monitored by a physician.

Chen, Y.. Lader. M. Long-term benzodiazepine treatment is it ever justified Hum. Psvchopharmacol. 5, 301-312, 1990. 

Petursson H Lader MH (1981). Withdrawal from long-term benzodiazepine treatment. British Medical Journal, 238, 643-5 Philips G, Gossop M Bradley M (1986). The influence of psychological factors on the opiate withdrawal syndrome. British Journal of Psychiatry, 149, 135-8 Philhps AN, Gazzard BG, Clumeck N, Losso MH Lundgren JD (2007). When should antiretroviral therapy for HIV be started British Medical Journal, 334, 76-8 Poikolainen K (2002). Antecedents of substance use in adolescence. Current Opinion in Psychiatry, 15, 241-5... 

Cassano GB, Castrogiovanni P, Conti I. Drug responses in different anxiety states under benzodiazepine treatment some multivariate analyses for evaluation of Rating Scale for Depression scores. In Garratini E, Mussini S, Randall LO, eds. The benzodiazapines. Ne w York Raven Press, 1973. 

Petursson H, Gudjonsson GH, Lader MH. Psychosomatic performance during withdrawal from long-term benzodiazepine treatment. Psychopharmacology 1983 81 345-349. 

Fontaine R, Chouinard G, Annable L. Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment. Am J Psychiatry 1984 141 848-852. 

Rickels K, DeMartinis N, Rynn M, et al. Pharmacologic strategies for discontinuing benzodiazepine treatment. J Clin Psychopharmacol 1999 19 12S-16S. 

Schneider LS, Syapin PJ, Pawluczyk S. Seizures following triazolam withdrawal despite benzodiazepine treatment. J Clin Psychiatry 1987 48 418-419. 

Roy-Byrne PP, Dager SR, Cowley DS, et al. Relapse and rebound following discontinuation of benzodiazepine treatment of panic attacks alprazolam versus diazepam. Am J Psychiatry 1989 146 860-865. 

Petursson, H. (1982) Clinical and laboratory studies of withdrawal from long-term benzodiazepine treatment , PhD thesis, London Institute of Psychiatry. 

Petursson, H. and Lader, M.H. (1981) Withdrawal from long-term benzodiazepines treatment , British Medical Journal, 283 643-5. 

The extensive clinical use of triazolam has led to reports of serious central nervous system effects including behavioral disinhibition, delirium, aggression, and violence. While behavioral disinhibition may occur with sedative-hypnotic drugs, it does not appear to be more prevalent with triazolam than with other benzodiazepines. Disinhibitory reactions during benzodiazepine treatment are more clearly associated with the use of very high doses and the pretreatment level of patient hostility. 

Depression All benzodiazepines have been associated with the emergence or worsening of depression whether they were causative or only failed to prevent the depression is unknown. When depression occurs during the course of benzodiazepine treatment, it is prudent to discontinue the benzodiazepine. 

There are more than 30 million people who take benzodiazepine drugs regularly each year more than 4 million are addicted. As with other benzodiazepines, treatment for Rohypnol dependence must be gradual, with use tapering off. 

Depression is commonly seen (94), either during benzodiazepine treatment or as a complication of withdrawal (SEDA-17, 42). Relief of anxiety symptoms can uncover pre-existing depression, rather than causing depression per se. In addition to their euphoriant effects in some individuals, benzodiazepines can directly increase irritability and depression and, less commonly, lead to fullblown manic episodes (95,96). 

The author concluded that interruption of benzodiazepine treatment had caused reduced growth hormone secretion and insulin requirements. 

Flumazenil has not been shown to treat hypoventilation due to benzodiazepine treatment... 

Extensive use of benzodiazepines may lead to psychological and physical dependence, withdrawal syndromes, and rebound insomnia on discontinuation of benzodiazepine treatment. 

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