Clinical uses of benzodiazepines. Focus on: benzodiazepines and anxiety disorders

Utilizzi clinici delle benzodiazepine. Focus on: benzodiazepine e disturbi d’ansia

L. Bossini, E. Borghini, A. Fagiolini

Università di Siena, Dipartimento di Medicina Molecolare e dello Sviluppo, Sezione Psichiatria

Benzodiazepines (BDZs) are usually safe and well-tolerated medications, which may be effectively prescribed in Anxiety Disorders and several other conditions requiring an anxiolytic and hypnotic therapeutic effect. Most often, BDZs should be considered as a complementary, rather than alternative, treatment to antidepressants such as SSRIs and SNRIs or to psychotherapies. Nonetheless, BDZs my be very useful tools both in the acute treatment phase , due to their ability to control anxious symptoms before the antidepressants start working, and in the continuation-maintenance treatment phase, as augmenting agents. BDZ have proven very effective in panic disorder, generalized anxiety and, even if to a lower degree, in social phobia. BDZ role in obsessive compulsive disorder and post traumatic stress disorder is not as strong but these medications may be useful for several patients with those diseases. BDZ are not devoid of side effects and risks such as tolerance and dependence. However, those risks may be reduced when BDZ are not used at high doses for long periods of time, when the choice of the specific compound is driven by an accurate evaluation of the specific pharmacokinetic properties and when patients at high risk of dependence are not prescribed these compounds, especially at high doses and for long periods of time.

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