Benzodiazepines and Other Sedatives and Hypnotics: Introduction | History | Behavioral Pharmacology | Neurobiology of Sedative-Hypnotic
Use Disorders | Epidemiology | Treatment | Key Points | References | Suggested Reading
In this chapter
I will discuss treatment strategies for individuals who abuse or
are dependent on benzodiazepines and other medications that have
sedative-hypnotic properties; that is, individuals who meet DSM-IV-TR
criteria for sedative, hypnotic, or anxiolytic use disorders (American Psychiatric Association 2000). Benzodiazepines are the most frequently
prescribed class of psychotropic agents. About 100 million prescriptions
are written annually for benzodiazepines, and 3%–4% of
adults in the United States and Canada are taking them at any one
time (Neutel 2005; Paulose-Ram et al. 2004).
Medications included in this class are used in a wide range of psychiatric
and medical conditions, including anxiety disorders, sleep disorders,
seizure disorders, movement disorders, and muscle spasticity. Sedative and
anxiolytic properties of these medications are used in the symptomatic
treatment of anxiety and agitation associated with other psychiatric
and neurological disorders, including psychotic, mood, and cognitive
(dementia, delirium) disorders (Hollister et al. 1993).
Sedative and hypnotic properties of these medications have a variety
of uses in anesthesiology and emergency medicine. These medications are
also used for the symptomatic treatment of syndromes related to
abuse of other drugs, such as agitation secondary to intoxication
with stimulants, as well as signs and symptoms associated with withdrawal
from alcohol, sedative-hypnotics, or opiates.