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Open AccessReview

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

by Jeffrey Guina 1,2,* and Brian Merrill 2
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.
J. Clin. Med. 2018, 7(2), 17; https://doi.org/10.3390/jcm7020017
Received: 21 December 2017 / Revised: 9 January 2018 / Accepted: 10 January 2018 / Published: 30 January 2018
(This article belongs to the Section Pharmacology)
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
MDPI and ACS Style

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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