David Baxter PhD
Late Founder
Some Concerns About Abuse of Benzodiazepines Unwarranted
Clinical Psychiatry News
Volume 34, Issue 3, Page 31 (March 2006)
by Linda Little
ALBUQUERQUE ? Prescribing practices for treating anxiety disorders are shifting from benzodiazepines to antidepressants?partly because of increasing concern about dependence and cognitive impairment with benzodiazepines as well as their potential for abuse. However, much of the concern is unwarranted, Dr. Carl Salzman said at a psychiatric symposium sponsored by the University of New Mexico.
Physicians must determine the risk vs. benefit for each drug class, said Dr. Salzman, who is affiliated with the Beth Israel Deaconess Medical Center and the Massachusetts Mental Health Center in Boston.
Benzodiazepines may be abused, as well as cause memory impairment and dependence with chronic use, but nearly all abuse is limited to substance abusers. Long-term therapeutic use does not lead to dose escalation, and memory impairment is mild, reversible, and does not occur in everyone.
Antidepressants are useful for anxiety spectrum disorders and mixed anxiety-depressive states but do not act rapidly. Serotonergic antidepressants commonly produce sexual dysfunction and blunted affect, and are associated with withdrawal symptoms when abruptly discontinued, said Dr. Salzman, also a professor of psychiatry at Harvard University in Boston.
Overall, benzodiazepines are safer than antidepressants. They do not impair cardiac function, alter hepatic enzymes, or lower seizure threshold. Thus, Dr. Salzman believes benzodiazepines should still be first-line treatment for anxiety. For patients who must choose between mild dependence vs. loss or reduced sexual function, benzodiazepines trump antidepressants.
Clinical Psychiatry News
Volume 34, Issue 3, Page 31 (March 2006)
by Linda Little
ALBUQUERQUE ? Prescribing practices for treating anxiety disorders are shifting from benzodiazepines to antidepressants?partly because of increasing concern about dependence and cognitive impairment with benzodiazepines as well as their potential for abuse. However, much of the concern is unwarranted, Dr. Carl Salzman said at a psychiatric symposium sponsored by the University of New Mexico.
Physicians must determine the risk vs. benefit for each drug class, said Dr. Salzman, who is affiliated with the Beth Israel Deaconess Medical Center and the Massachusetts Mental Health Center in Boston.
Benzodiazepines may be abused, as well as cause memory impairment and dependence with chronic use, but nearly all abuse is limited to substance abusers. Long-term therapeutic use does not lead to dose escalation, and memory impairment is mild, reversible, and does not occur in everyone.
Antidepressants are useful for anxiety spectrum disorders and mixed anxiety-depressive states but do not act rapidly. Serotonergic antidepressants commonly produce sexual dysfunction and blunted affect, and are associated with withdrawal symptoms when abruptly discontinued, said Dr. Salzman, also a professor of psychiatry at Harvard University in Boston.
Overall, benzodiazepines are safer than antidepressants. They do not impair cardiac function, alter hepatic enzymes, or lower seizure threshold. Thus, Dr. Salzman believes benzodiazepines should still be first-line treatment for anxiety. For patients who must choose between mild dependence vs. loss or reduced sexual function, benzodiazepines trump antidepressants.
