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In clinical practice, benzodiazepine dependence should be suspected in those having used benzodiazepines for longer than a month, in particular, if they are from a high-risk group. The main factors associated with an increased incidence of benzodiazepine dependence include: [51] Dose; Duration; Concomitant use of antidepressants
Benzodiazepine use disorder (BUD), also called misuse or abuse, [1] is the use of benzodiazepines without a prescription and/or for recreational purposes, which poses risks of dependence, withdrawal and other long-term effects. [2] [3] Benzodiazepines are one of the more common prescription drugs used recreationally.
Long-term use of benzodiazepines can induce perceptual disturbances and depersonalization in some people, even in those taking a stable daily dosage, and it can also become a protracted withdrawal feature of the benzodiazepine withdrawal syndrome. [54] In addition, chronic use of benzodiazepines is a risk factor for blepharospasm. [55]
Management of benzodiazepine dependence involves considering the person's age, comorbidity and the pharmacological pathways of benzodiazepines. [70] Psychological interventions may provide a small but significant additional benefit over gradual dose reduction alone at post-cessation and at follow-up. [71]
Tolerance and dependence are risks of chronic benzodiazepine use, and can result in doses within the therapeutic range ceasing to offer meaningful symptomatic relief after prolonged use. Tolerance develops at different rates and to different degrees to the sedative, hypnotic, anticonvulsant, muscle relaxant and anxiolytic effects of benzodiazpines.
[4] [5] Physical dependence can develop from low-dose therapeutic use of certain medications such as benzodiazepines, opioids, stimulants, antiepileptics and antidepressants, as well as the recreational misuse of drugs such as alcohol, opioids and benzodiazepines. The higher the dose used, the greater the duration of use, and the earlier age ...
There is some evidence that a prior history of CNS depressant dependence (e.g. alcohol) increases the risk of dependence on benzodiazepines. Tolerance to drugs is commonly believed to be due to receptor down-regulation ; however, there is very limited evidence to support this, and this hypothesis comes from animal studies using very high doses.
Finally, note that the benzodiazepine core is a privileged scaffold, which has been used to derive drugs with diverse activity that is not limited to the GABA A modulatory action of the classical benzodiazepines, [60] such as devazepide and tifluadom, however these have not been included in the list below. 2,3-benzodiazepines such as tofisopam ...