Benzodiazepines and other anxiolytics/sedative-hypnotics

Question 1

What is the range of halflives of the benzodiazepines? Which has the longest and which the shortest?

Answer 1

Diazepam: 20-70h, Lorazepam: 10-70h, Clonazepam: 19-50h; Alprazolam: 8-15h; Oxazepam: 5-15h; Temazepam: 8-12h; Triazolam: 1.5-5h; Midazolam: 1.5-3.5h

Question 2

What anxiolytic is indicated for generalized anxiety disorder? What is the halflife, side effects and contraindications?

Answer 2

Buspirone; 5-11h; Headache, GI distress, dizziness; not used with MAOIs, less useful if already used benzos.

Question 3

Which drugs are used for insomnia? What is their halflife, side effect and any interaction?

Answer 3

Zolpidem; 2-4h; Headache, drowsiness, dizziness, nausea, diarrhea; increased with alcohol or SSRIs. Zaleplon; 1h; same side effects plus peripheral edema, amnesia, dizziness, rash, nausea, tremor.