Benzodiazepines

Question 1

Mechanism of action of benzodiazepines

(think opposite of alcohol withdrawal as they are used to treat it!)

Answer 1

enhance inhibitory GABA by increasing the frequency of chloride channels

Question 2

Uses of benzodiazepines

Answer 2

sedation
hypnotic
anxiolytic
anticonvulsant
muscle relaxant

Question 3

For how long should benzodiazepines be prescribed?

Answer 3

short period of time (2-4 weeks)

Question 4

Describe how a dose of benzodiazepines should be weaned

Answer 4

Step down of ~1/8 of the daily dose every fortnight.

Suggested protocol:
- switch patients to equivalent dose of diazepam
- reduce every 2 weeks in steps of 2 or 2.5 mg

Question 5

Describe the symptoms of benzodiazepine withdrawal

Answer 5

insomnia
irritability
anxiety
tremor
loss of appetite
tinnitus
perspiration
perceptual disturbances
seizures

Question 6

When may benzodiazepine withdrawal occur?

Answer 6

Up to 3 weeks after withdrawing the medication

Question 7

Why are the symptoms of benzodiazepine withdrawal similar to alcohol withdrawal?

Answer 7

Both act on inhibitory GABA neurotransmitter