Benzodiazepine problems

Question 1

Care should be taken with

Answer 1

Long-term use should be avoided

Care should be taken with ‘new pts’ requesting a prescription.

Question 2

Have a firm prescribing policy

Answer 2

Have a firm prescribing policy, e.g. reserving for:

• situational anxiety affecting lifestyle
  (e. g. plane travel—intermittent short use only)
• self-perpetuating anxiety following a precipitating event, not responding to counselling etc.

(give short course 2–4 wks)

• emergency short-term use for agoraphobia and panic attacks

Question 3

Benzodiazepine withdrawal syndrome

Answer 3

usu. relatively delayed in its onset and may continue for weeks or mths.

Withdrawal features include:

• anxiety (rebound)
• depression
• insomnia
• nausea
• loss of appetite
• tremor
• confusion
• delirium

Question 4

An effective management method is to;

Answer 4

withdraw the drug very slowly while;

• providing counselling and support
• including referral to a self-help group

Antidepressants can be substituted if there is evidence of depression

while beta-blockers may help the withdrawal syndrome if other measures have failed.

If severe, hospitalisation is required.