All are true of benzodiazepines except:
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Benzodiazepam is used in the long term treatment of psychic disorders
Description:
Benzodiazepines are effective for the treatment of anxiety symptoms secondary to panic disorder, generalized anxiety disorder (GAD), social anxiety disorder, performance anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, and extreme anxiety associated with phobias, such as fear of flying.
The benzodiazepines are also useful in treating anxiety related to depression and schizophrenia.
Clonazepam is occasionally used as adjunctive therapy for certain types of seizures, whereas lorazepam and diazepam are the drugs of choice in terminating status epilepticus. Due to cross-tolerance, chlordiazepoxide, clorazepate, diazepam, lorazepam, and oxazepam are useful in the acute treatment of alcohol withdrawal and reduce the risk of withdrawal-related seizures.
One area of concern regarding the use of benzodiazepines in the treatment of anxiety is the potential for habituation, dependence, and abuse. Patients with certain personality disorders or a history of drug or alcohol abuse are particularly susceptible. However, the risk of dependence must be balanced with the need for treatment, since benzodiazepines are effective in both short- and long-term treatment of patients with sustained or recurring bouts of anxiety. Further, premature discontinuation of benzodiazepines, in the absence of other pharmacological treatment, results in a high rate of relapse. Withdrawal of benzodiazepines after chronic treatment, particularly those with short duration of action, can include increased anxiety and seizures. For this reason, it is important that discontinuation be earned out in a gradual manner.
Benzodiazepines cause many adverse effects. including sedation, mild memory impairments. decreased alertness, and slowed reaction time (which may lead to accidents). Memory problems can include visual-spatial deficits, but will manifest clinically in a variety of ways, including difficulty in word-finding. Occasionally, paradoxical reactions can occur with benzodiazepines such as an increase
in anxiety, sometimes reaching panic attack proportions. Other pathological reactions can include irritability, aggression, or behavioral disinhibition. Amnesic reactions (i.e., loss of memory for particular periods) can also occur. Benzodiazepines should not be used in pregnant women; there have been rare reports of craniofacial defects. In addition, benzodiazepines taken prior to delivery may result in sedated, under-responsive newborns and prolonged withdrawal reactions. In the elderly, benzodiazepines increase the risk of falls and must be used cautiously. These drugs are safer than classical sedative-hypnotics in overdosage and typically are fatal only if combined with other CNS depressants.
Reference: Lippincott Illustrated Reviews: Pharmacology Wolters Kluwer Sixth Edition page no 151,110
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