Physiologic dependence with sedative-hypnotics

Even normal therapeutic doses of benzodiazepines may lead to physiologic dependence with withdrawal symptoms. These can include increases in REM sleep (REM rebound), increased anxiety, agitation, and insomnia. The severity of withdrawal symptoms depends on the dose used and on the concomitant use of other sedative-hypnotics, including ethanol. In general, withdrawal symptoms are more severe with the use of shorter-acting sedative-hypnotics. The answer is (E). 

Flunitrazepam (Rohypnol), also known as roofies, is a benzodiazepine with physiological effects similar to diazepam (Valium), although it is about 10 times more potent. The drug produces sedative-hypnotic effects that include muscle relaxation and amnesia it can also produce physical and psychological dependence. It is illegal and not approved for use in the United States. 

With the chronic use of sedative-hypnotics, especially if doses are increased, a state of physiologic dependence can occur. This may develop to a degree unparalleled by any other drug group,... 

From the published clinical studies, it would appear that the partial agonists bretazenil and abercamil are less likely to cause physiological dependence, have lower reinforcing effects and a lower incidence of subjective effects associated with abuse liability than the conventional 1,4-benzodiazepine sedative-hypnotics. It is presently unclear whether the full agonists for the GABA-A receptor, zolpidem and zopiclone, offer a real advance in the treatment of insomnia although their adverse effect profiles and abuse liability may be lower than that of the conventional benzodiazepines. 

Benzodiazepine sedative-hypnotic widely used in anxiety states, selectivity for panic attacks and phobias possible antidepressant actions. Tox psychologic and physiologic dependence, additive effects with other CNS depressants. 

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