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Benzodiazepines

Risks, Benefits & Accidental Deaths

Chris Aiken, MD

Editor-in-Chief, The Carlat Report

Instructor, WFU Dept of Psychiatry

Director, Mood Treatment Center

NCPA, September 2019

Disclosures

None

Thanks to

Richard Weisler and

Daniel Carlat for

help in preparing

this talk

Benefits

Ideal Use

Short term (1-3 months) treatment of

? Anxiety that is debilitating but temporary

? Insomnia

? Seizures

? Muscle relaxant

? Seizures

? Slow-wave sleep d/o (sleep walking, night terrors)

? Alcohol withdrawal

Source: World Health Organization (1996) and Food and Drug Administration

FDA Approved Benzos in Panic Disorder

Daily dose in mg

Best

Evidence is

in Panic

Disorder

Starting

Max

Typical

Alprazolam

1-1.5

10

2-5

Clonazepam

0.5-1

4

1-2

Longest panic data

8 mth controlled (alprazolam) or 12 mth uncontrolled (clonazepam)

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