Benzodiazepines, the good, the bad, and the alternatives
BENZODIAZEPINES: the good, the bad, and the alternatives
Alec Chang, DO University of Nevada, Reno School of Medicine Department of Psychiatry
Indications
? Generalized anxiety disorder ? Panic disorder ? Anxiety associated with depression ? Other anxiety disorders
Pharmacology
? Modulate gamma-aminobutyric acid A (GABA-A) receptors
? GABA is the primary inhibitory neurotransmitter of CNS
? Locks receptor into configuration with higher GABA affinity
? Increases frequency at which the GABA channel opens ? Influx of chloride ions leads to reduced rate of muscle
and neuronal firing
Intoxication and Overdose
? Intoxication
? Somnolence ? Slurred speech ? Ataxia ? Irritability ? Elevated or labile mood
? Overdose
? Alcohol increases risk of respiratory suppression ? Flumazenil for acute reversal, but a/w risk of inducing
withdrawal seizure in chronic users
Short-Acting Benzos
? Half-life ................
................
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