Benzodiazepine dependence : a review

Abstract

Benzodiazepines are a very widely used class of drug with worldwide sales exceeding $1000 million. Although a considerable number of prescriptions are for long term users there is no convincing evidence that benzodiazepines remain effective over long periods. Dependence occurs even with regular therapeutic dosage for more than a few weeks. Also discontinuation may lead to rebound anxiety and a withdrawal syndrome. The latter will usually need management in its own right and this often can be carried out by general practitioners. Prevention of dependence, after all an iatrogenic disorder, must be our future aim. Initial prescribing has to be appropriate, and other forms of intervention should be considered. Non specialised GP counselling is as effective as benzodiazepines in the treatment of minor affective disorder. Benzodiazepines are the most frequently prescribed drug in the Western World. At present one in five people in developed countries are given minor tranquillisers at a point during their life.