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Family Practice Vol. 20, No. 3, 347-349
© Oxford University Press 2003

Selections from Current Literature

Benzodiazepines revisited

Robert S Bobrow

Health Sciences Center L-4, Department of Family Medicine, State University of New York, Stony Brook, NY 11794, USA.

Bobrow RS. Benzodiazepines revisited. Family Practice 2003; 20: 347–349.

The first 150 words of the full text of this article appear below.

Having practised during the era when barbiturates were used as anxiolytics and hypnotics, I have a great appreciation for benzodiazepines. Unlike barbiturates, sudden withdrawal was never fatal, and suicide was virtually impossible if benzodiazepines were used alone. The first drug of this class, chlordiazepoxide (Librium) was approved in the USA in 1961, followed by diazepam (Valium) in 1969, which stayed at the top of the best-selling prescription drug list for a decade. Originally touted as having neither addiction potential nor causing a withdrawal syndrome, anecdotal reports in the late 1970s followed by more reliable reports in the 1980s established some evidence of abuse potential and discontinuation symptoms. Although these problems were relatively mild, sensationalistic lay press reports1 fuelled a perception that benzodiazepines were overused, dangerous drugs, and some states, such as New York, made them controlled substances, subject to similar prescribing restrictions as narcotics and barbiturates.

Benzodiazepine Dependence, Toxicity and Abuse. Washington (DC): American Psychiatric Association, 1990 (Chapter 3, Patterns of benzodiazepine use).

Roy-Byrne P, Russo J, Dugdale DC et al. Undertreatment of panic disorder in primary care: role of patient and physician characteristics. J Am Board Fam Pract 2002; 15: 443–450.

Concerns about the dangers . . . [Full Text of this Article]

Comment
Shader RI, Greenblatt DJ. Use of benzodiazepines in anxiety disorders. N Engl J Med 1993; 328: 1398–1405.

Comment
Shader RI, Greenblatt DJ. Use of benzodiazepines in anxiety disorders. N Engl J Med 1993; 328: 1398–1405.

Salzman C. An 87-year-old woman taking a benzodiazepine. (Clinical Crossroads) J Am Med Assoc 1999; 281 (12).

Comment
Paterniti S, Dufouil C, Alperovitch A. Long-term benzodiazepine use and cognitive decline in the elderly: the epidemiology of vascular aging study. J Clin Psychopharmacol 2002; 22: 285–293.

Wang PS, Bohn RL, Glynn RJ et al. Hazardous benzodiazepine regimens in the elderly: effects of half-life, dosage and duration on risk of hip fracture. Am J Psychiatry 2001; 158: 892–898.

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