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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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