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Benzodiazepine Basics

A brief overview of the ups and downs of BZDs
by

Craig Strickland

on 2 August 2013

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Transcript of Benzodiazepine Basics

Benzodiazepines: Yes or No?
Benzodiazepines: A Model for Central Nervous System (CNS) Depressants

Clinical Uses of BZDs

Where? BZD receptor binding highest in:
Cerebral cortex
Hippocampus (& perhaps other limbic system structures)
Cerebellum (coordination)

More moderate (but significant) binding in
Hypothalamus, thalamus
Basal ganglia (movement)

Pharmacodynamics: How BZDS work

The Gamma-aminobutyric acid (GABA) receptor complex

BZD Pharmacokinetics


Treat a variety of anxiety disorders
Hypnotics
Muscle relaxants
To produce anterograde amnesia
Alcohol & other CNS depressant withdrawal
Anti-convulsants

Conclusion/Summary
Assess anxiety & medication needs
R/o medical etiology
Pay attention to wellness approaches to treating anxiety
Use BZDs sparingly if at all possible
If BZDs prescribed: use long 1/2 life BZDs
Time limit the use
Monitor closely
Consider alternative strategies
https://sites.google.com/site/myheadmeds/
Assess need for any anti-anxiety compounds; if no then
Tapering strategies
Switch from short to high 1/2 life
Taper with current benzodiazepine
If continued treatment for anxiety is warrented then:
Combination therapy (BZDs and Buspar or an SSRIs
Use of NE antagonists (Clonidine or Inderal)
Seroquel (careful with abuse potential)
Suggest non-pharmaceutical strategies for anixety
Guided imagery or aroma therapy
CBT
Relaxation or breathing techniques
Herbal, amino acid therapies
Eliminate raw sugars, caffeine and alcohol
Sleep assessment
What to Do?
Full transcript