Benzodiazepine Essay

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BENZODIAZEPINES: USE, ABUSE, WITHDRAWAL AND DEPENDENCE

INTRODUCTION: Benzodiazepine is considered as a drug with high addictive potential. Dependence develops with long term use of even with therapeutic dose. As benzodiazepines are widely prescribed for various conditions, particularly insomnia and anxiety, therapeutic dose dependence are the largest category of people dependent on benzodiazepine. Benzodiazepines are one of the most prescribed drugs which have abuse potential. There must be special attention toward the patient's addiction history before these agents are prescribed. Understanding the abuse pattern and alternative anxiolytic and hypnotic agent can help health care providers maximize treatment result and reduce medico legal liability.

Mechanism of action
It acts by following ways

• Benzodiazepine receptors are linked mainly to γ amino butyric acid (GABA) receptors, which sensitize benzodiazepine receptors to the neurotransmitter GABA, the most prominent inhibitory neurotransmitter in the central nervous system.
• Accentuates the affinity of the recognition site for GABA by inducing conformational changes that make GABA binding more efficacious.
• Activation of the benzodiazepine- GABA-chloride ionophor complex is responsible for producing the therapeutic anxiolytic effects of benzodiazepines and for mediating many of the side effects and, possibly, dependence and withdrawal from these drugs.

Clinical use
Following are the use of benzodiazepines
• Amnesia before or after surgery
• Anxiety disorders
 Generalized anxiety disorder
 Panic disorder
 Phobias (social, simple)
 Post-traumatic stress disorder
 Obsessive-compulsive disorder
• Insomnia
• Somatoform disorder
• Convulsive disorders
• Tetanus
• Parapleg...

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...cts or side effects.
 Clonazepam is a high-potency benzodiazepine with a long half-life. It is widely prescribed for a variety of psychiatric and neurologic conditions. Although clonazepam is perceived as “safe,” addiction medicine specialists have found that it is also frequently abused as a street drug. On the other hand, oxazepam (Serax), clorazepate (Tranxene) and chlordiazepoxide appear to have lower reinforcing effects than other benzodiazepines

CONCLUSION: Benzodiazepine remains to be one of the most prescribed agent for variety of anxiety and sleep disorders. Keeping in mind their highly abusive potential clinician must pay special attention towards patient’s addiction and medication history before these agents are prescribed. Proper education of patient, regular follow up and using alternative therapy can reduce the risk of benzodiazepine dependence.
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