Benzodiazepines

Question 1

How do benzodiazepines work?

Answer 1

Enhance the effect of the INHIBITORY neurotransmitter GABA (gamma-aminobutyric acid) by INCREASING the FREQUENCY of chloride channels

Question 2

What are the 5 uses of benzodiazepines?

Answer 2

Sedation
Hypnotic
Anxiolytic
Anticonvulsant
Muscle relaxant

Question 3

Why should care be exercised when prescribing benzodiazepines and how long should they be prescribed for?

Answer 3

Patients develop tolerance and dependence on them

Only short period of time (2-4 weeks)

Question 4

How do is it advised to withdraw patients from benzodiazepines?

Answer 4

Dose should be withdrawn in steps of 1/8 of the daily dose every fortnight (range 1/10-1/4)
For difficult patients:
- switch to equivalent dose of diazepam
- reduce dose of diazepam every 2-3 weeks by 2-2.5mg
This can take anywhere from 4 weeks to a year or more

Question 5

Why is it important to control the withdrawal of benzodiazepines?

Answer 5

May result in benzodiazepine withdrawal syndrome up to 3 weeks after stopping the long-acting drug

Question 6

What are the 9 potential features of benzodiazepine withdrawal syndrome?

Answer 6

Insomnia
Irritability
Anxiety
Tremor
Loss of appetite
Tinnitus
Perspiration
Perceptual disturbances
Seizures

Question 7

What is the difference between benzodiazepines and barbiturates?

Answer 7

Benzodiazepines - increase FREQUENCY of chloride channels

Barbiturates - increase DURATION of chloride channel opening