Benzodiazepines Causing Aggression

Abstract

The benzodiazepines are among the most prescribed drugs in medical practice. They are all derivatives of the 1, 4-benzodiazepine nucleus and include the so-called minor tranquillisers (diazepam, chlordiazepoxide, oxazepam, lorazepam, medazepam and potassium clorazepate) and the hypnotics (nitrazepam and flurazepam). From the early 1960s when chlordiazepoxide was first available for use in clinical practice the benzodiazepines have been a major growth industry for the pharmaceutical corporations. In 1970, for instance, in Britain the combined total number of EC 10 prescriptions (effectively all from general practice) for chlordiazepoxide, diazepam and nitrazepam 14 971 000, compared to 3 361 000 for digoxin or 7 948 000 for ampicillin (Committee on Safety of Medicines, 1964 to 1973). In 1972 in the United States prescriptions from retail pharmacies for benzodiazepine tranquillisers and hypnotics were approximately 81 million (Greenblatt and Shader, 1974). The expenditure on these exceeded 200 million dollars. Unfortunately there are no comprehensive studies of treatment adherence (drug compliance) specifically for benzodiazepines, but Blackwell (1976) has stated that non-adherence of out-patients to medical treatment in general, is between 25 and 50 per cent. If the, lower of these percentages is applied to the American figures for 1972 we arrive at a rough estimate of 50 million dollars worth of wasted drugs, which speaks for itself.