Benzodiazepines in clinical practice: consideration of their long-term use and alternative agents.
Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety, benzodiazepines have remained a mainstay of anxiolytic pharmacotherapy due to their robust efficacy, rapid onset of therapeutic effect, and generally favorable side effect profile. In this article, we examine issues related to the long-term use of benzodiazepines, including concerns about the development of therapeutic tolerance, dose escalation, and adverse cognitive effects. We also consider currently available alternatives to benzodiazepines and novel mechanisms of action that may prove fruitful in the development of future generations of anxiolytics.
Stevens
Julie C
JC
Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA 02114, USA.
Pollack
Mark H
MH
D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004361:Drug Tolerance; D006801:Humans; D008134:Long-Term Care; D000069583:Pregabalin; D018570:Risk Assessment; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000523:psychology; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid