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The
benzodiazepine family of depressants is used therapeutically
to produce sedation, induce sleep, relieve anxiety
and muscle spasms, and to prevent seizures. In general,
benzodiazepines act as hypnotics in high doses,
anxiolytics in moderate doses, and sedatives in
low doses. Of the drugs marketed in the United States
that affect central nervous system function, benzodiazepines
are among the most widely prescribed medications.
Fifteen members of this group are presently marketed
in the United States, and about 20 additional benzodiazepines
are marketed in other countries.
Short-acting benzodiazepines are generally used
for patients with sleep-onset insomnia (difficulty
falling asleep) without daytime anxiety. Shorter-acting
benzodiazepines used to manage insomnia include
estazolam (ProSom®), flurazepam (Dalmane®),
temazepam (Restoril®), and triazolam (Halcion®).
Midazolam (Versed®), a short-acting benzodiazepine,
is utilized for sedation, anxiety, and amnesia in
critical care settings and prior to anesthesia.
It is available in the United States as an injectable
preparation and as a syrup (primarily for pediatric
patients).
Benzodiazepines with a longer duration of action
are utilized to treat insomnia in patients with
daytime anxiety. These benzodiazepines include alprazolam
(Xanax®), chlordiazepoxide (librium®), clorazepate
(Tranxene®), diazepam (Valium®, halazepam
(Paxipam®), lorzepam (Ativan®), oxazepam
(Serax®), prazepam (Centrax®), and quazepam
(Doral®). Clonazepam (Klonopin®), diazepam,
and clorazepate are also used as anticonvulsants.
Benzodiazepines are classified in the CSA as depressants.
Repeated use of large doses or; in some cases, daily
use of therapeutic doses of benzodiazepines is associated
with amnesia, hostility, irritability, and vivid
or disturbing dreams, as well as tolerance and physical
dependence. The withdrawal syndrome is similar to
that of alcohol and may require hospitalization.
Abrupt cessation of benzodiazepines is not recommended
and tapering-down the dose eliminates many of the
unpleasant symptoms.
Source: DEA |
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