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J. Clin. Med. 2018, 7(2), 17; https://doi.org/10.3390/jcm7020017

Benzodiazepines I: Upping the Care on Downers: The Evidence of Risks, Benefits and Alternatives

1
Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI 48109, USA
2
Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH 45435, USA
*
Author to whom correspondence should be addressed.
Received: 21 December 2017 / Revised: 9 January 2018 / Accepted: 10 January 2018 / Published: 30 January 2018
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Abstract

Benzodiazepines are some of the most commonly prescribed medications in the world. These sedative-hypnotics can provide rapid relief for symptoms like anxiety and insomnia, but are also linked to a variety of adverse effects (whether used long-term, short-term, or as needed). Many patients take benzodiazepines long-term without ever receiving evidence-based first-line treatments (e.g., psychotherapy, relaxation techniques, sleep hygiene education, serotonergic agents). This review discusses the risks and benefits of, and alternatives to benzodiazepines. We discuss evidence-based indications and contraindications, and the theoretical biopsychosocial bases for effectiveness, ineffectiveness and harm. Potential adverse effects and drug-drug interactions are summarized. Finally, both fast-acting/acute and delayed-action/chronic alternative treatments for anxiety and/or insomnia are discussed. Response to treatment—whether benzodiazepines, other pharmacological agents, or psychotherapy—should be determined based on functional recovery and not merely sedation. View Full-Text
Keywords: benzodiazepine; sedative; hypnotic; anxiolytic; psychopharmacology; alprazolam; clonazepam; evidence-based benzodiazepine; sedative; hypnotic; anxiolytic; psychopharmacology; alprazolam; clonazepam; evidence-based
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Guina, J.; Merrill, B. Benzodiazepines I: Upping the Care on Downers: The Evidence of Risks, Benefits and Alternatives. J. Clin. Med. 2018, 7, 17.

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