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Urgent action by national governments has been recommended to improve prescribing patterns of benzodiazepines such as diazepam. [125] [126] A single dose of diazepam modulates the dopamine system in similar ways to how morphine and alcohol modulate the dopaminergic pathways. [127] Between 50 and 64% of rats will self-administer diazepam. [128]
[35] [36] However a 2016 study found no association between long-term usage and dementia. [37] ... however, high prescribed doses of diazepam, in humans, have been ...
[citation needed] For example, the equivalent dose of diazepam in an elderly individual on lorazepam may be half of what would be expected in a younger individual. [7] [8] Equivalent doses of benzodiazepines differ as much as 20 fold. [9] [10] [11]
In a study of long term diazepam use, withdrawal phenomena occurred in 5% of patients taking diazepam for less than 8 months and 43% of patients taking diazepam for more than 8 months. [17] This can lead to benzodiazepines being taken for longer than originally intended, as people continue to take the drugs over a long period of time to ...
Withdrawal is best managed by transferring the physically dependent patient to an equivalent dose of diazepam because it has the longest half-life of all of the benzodiazepines, is metabolised into long-acting active metabolites and is available in low-potency tablets, which can be quartered for smaller doses. [152]
The consensus is to reduce dosage gradually over several weeks, e.g. 4 or more weeks for diazepam doses over 30 mg/day, [1] with the rate determined by the person's ability to tolerate symptoms. [120] The recommended reduction rates range from 50% of the initial dose every week or so, [121] to 10–25% of the daily dose every 2 weeks. [120]
Nevertheless, as long as the drug is present it will exert subtle effects within the body. These effects may become apparent during continued use or may appear as withdrawal symptoms when dosage is reduced or the drug is stopped. [citation needed] ***Equivalent doses are based on clinical experience but may vary between individuals. [34]
It is mainly an anti-anxiety agent with similar side effects to diazepam. In addition to being used to treat anxiety or panic states, bromazepam may be used as a premedicant prior to minor surgery. Bromazepam typically comes in doses of 3 mg and 6 mg tablets. [4] It was patented in 1961 by Roche and approved for medical use in 1974. [5]