The Pharmacology of Benzodiazepines

  • Norman S. Miller


The benzodiazepines have been and remain among the most prescribed drugs in the United States and the world since their introduction in 1961. Of interest is that four of the 10 most commonly written prescriptions in 1987 were for drugs used for the relief of pain and anxiety; currently, 1 of these is the benzodiazepine Xanax.


Drug Addict National Household Survey Original Symptom Reach Peak Concentration Drug Abuse Warning Network 
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  1. 1.
    Anon (1988). Top 200 drugs of 1987. Am Druggist197 (2):36–52.Google Scholar
  2. 2.
    DuPont RL, ed. (1988). Abuse of benzodiazepines: The problems and the solutions. A report of a committee of the Institute for Behavior and Health, Inc. Am J Drug Alcohol Abuse 14(Suppl l):l–69.Google Scholar
  3. 3.
    Noyes R, Garvey MJ, Cook BL, et al. (1988). Benzodiazepine withdrawal: A review of the evidence. J Clin Psychiatry49 (10):382–389.PubMedGoogle Scholar
  4. 4.
    American Medical Association (1987). Drug Evaluations, Antianxiety and Hypnotic Drugs, 6th Ed., pp. 86–103. Chicago: American Medical Association.Google Scholar
  5. 5.
    Owen RT, Tyrer P (1983). Benzodiazepine dependence: A review of the evidence. Drugs25:385–398.PubMedCrossRefGoogle Scholar
  6. 6.
    Ashton H (1987). Benzodiazepine withdrawal: Outcome in 50 patients. Br J Addict82:665–671.PubMedCrossRefGoogle Scholar
  7. 7.
    Lader M (1983). Dependence on benzodiazepines. J Clin Psychiatry44:121–127.PubMedGoogle Scholar
  8. 8.
    Ashton H (1984). Benzodiazepine withdrawal: An unfinished story. Br Med J288:1135–1140.CrossRefGoogle Scholar
  9. 9.
    Griffiths RR, Sannerud CA (1987). Abuse of and dependence on benzodiazepines and other anxiolytic/sedative drugs. In Psychopharmacology, Meitzer HY, ed., pp. 1535–1541. New York: Raven Press.Google Scholar
  10. 10.
    Clinthorne MA, Cisin IH, Balter MB (1986). Changes in popular attitudes and belief about tranquilizers. Arch Gen Psychiatry43:527–532.PubMedGoogle Scholar
  11. 11.
    Ashton H (1986). Adverse effects of prolonged benzodiazepine use. Adverse Drug Reac Bull118:440–443.CrossRefGoogle Scholar
  12. 12.
    Miller NS, Dackis CA, Gold MS (1987). The relationship of addiction, tolerance and dependence: A neurochemical approach. JSubst Abuse Treat4:197–207.CrossRefGoogle Scholar
  13. 13.
    National Institute on Drug Abuse (1982). National Household Survey on Drug Abuse (1979–1981). Washington, DC: US Govt. Printing Office.Google Scholar
  14. 14.
    National Institute on Drug Abuse (1985). National Household Survey on Drug Abuse (1982–1984). Washington, DC: US Govt. Printing Office.Google Scholar
  15. 15.
    Mellinger GD, Balter MB, Uhlenhuth ET (1984). Antianxiety agents: Duration of use and characteristics of users in the USA. CurrMed Res Opin8 (Suppl): 4.CrossRefGoogle Scholar
  16. 16.
    Mellinger GD, Baiter MB, Uhlenhuth ET (1984). Prevalence and correlates of the long-term regular use of anxiolytics. JAMA251 (3): 375–379.PubMedCrossRefGoogle Scholar
  17. 17.
    Smith DE, Wesson DR, eds. (1985). The Benzodiazepines: Current Standards for Medical Practice. Lancashire, UK: MTP Press Limited.Google Scholar
  18. 18.
    Smith DE, Wesson DR (1983). Benzodiazepine dependence syndromes. J Psy-choact Drugs15 (l–2): 85–95.Google Scholar
  19. 19.
    Rosenberg HC, Chiù TH (1985). Time course for development of benzodiazepine tolerance and physical dependence. Neurosci Biobehav Rev9:123–131.PubMedCrossRefGoogle Scholar
  20. 20.
    Rickels MD, Case G, Schweizer EE, et al. (1986). Low-dose dependence in chronic benzodiazepine users: A preliminary report on 119 patients. Psycho-pharmacol Bull 22(2):407–415.Google Scholar
  21. 21.
    Busto U, Sellers EM, Claudio NA, et al. (1986). Withdrawal reaction after long-term therapeutic use of benzodiazepines. N Engl J Med, 000:854–869.CrossRefGoogle Scholar
  22. 22.
    Juergens SM, Morse RM (1988). Alprazolam dependence in seven patients. Am J Psychiatry145 (5): 625–627.PubMedGoogle Scholar
  23. 23.
    Murphey SM, Tyrer P (1988). The essence of benzodiazepine dependence. In The Psychopharmacology of Addiction, Lader M, ed., pp. 157–166. New York: Oxford University Press.Google Scholar
  24. 24.
    Tyrer PJ, Seivewright N (1984). Identification and management of benzodiazepine dependence. Postgrad Med J60 (Suppl 2): 41–46.PubMedGoogle Scholar
  25. 25.
    Tyrer P, Rutherford D, Huggett T (1981). Benzodiazepine withdrawal symptoms and propranolol. Lancet1:520–522.PubMedCrossRefGoogle Scholar
  26. 26.
    Lader M, Olajide D (1987). A comparison of buspirone ahd placebo in relieving benzodiazepine withdrawal symptoms. J Clin Psychopharmacol7 (1): 11–15.PubMedCrossRefGoogle Scholar
  27. 27.
    Pertusson H, Lader MH (1981). Withdrawal from long-term benzodiazepine treatment. Br Med J 283:643–645.Google Scholar
  28. 28.
    Greenblatt DJ, Harmatz JS, Zinny MA, Shader RI (1987). Effect of gradual withdrawal on the rebound sleep disorder after discontinuation of triazolam. N EnglJ Med317:772–728.Google Scholar
  29. 29.
    Mellman T, Uhde TW (1986). Withdrawal syndrome with gradual tapering of alprazolam. Am J Psychiatry143 (11): 1464–1466.PubMedGoogle Scholar
  30. 30.
    Lader M (1988). The psychopharmacology of addiction: Benzodiazepine tolerance and dependence. In The Psychopharmacology of Addiction, Lader M, ed., pp. 1–13. Cambridge: Oxford University Press.Google Scholar
  31. 31.
    Hallstrom L, Lader M (1981). Benzodiazepine withdrawal phenomena. Int Pharmacopsychiatry16:235–244.PubMedGoogle Scholar
  32. 32.
    Fyer A, Liebowitz Mil, Gorman JM, et al. (1987). Discontinuation of alprazolam treatment in panic patients. Am J Psychiatry144:303–308.PubMedGoogle Scholar
  33. 33.
    Robins LN, Heizer JE, Przybeck TR, et al. (1988). Alcohol disorders in the community: A report from the epidemiological catchement area. In Alcoholism: Origins and Outcome, Rose RM, Barrett J, eds., pp. 15–29. New York: Raven Press.Google Scholar
  34. 34.
    Greenblatt DJ, Shader RI, Divoll M, et al. (1981). Benzodiazepines: A summary of pharmacokinetic properties. Br J Clin Pharmacol (Suppl) 11:11S–16S.Google Scholar
  35. 35.
    Haefely W (1986). Biological basis of drug-induced tolerance, rebound and dependence. Contribution of recent research on benzodiazepines. Pharmacopsychiatry19:353–361.PubMedCrossRefGoogle Scholar
  36. 36.
    Jaffe JH (1985). In The Pharmacological Basis of Therapeutics, 7th Ed., Gilman AG, Goodman LS, Rail TW, Murad F, eds., pp. 532–581. New York: Macmillan.Google Scholar
  37. 37.
    Sellers EM, Marshman JA, Kaplan HL, et al. (1981). Acute and chronic drug abuse emergencies in metropolitan Toronto. Int J Addict16 (2): 283–303.PubMedGoogle Scholar
  38. 38.
    Grantham P (1987). Benzodiazepine abuse. Br JHosp Med37:999–1001.Google Scholar
  39. 39.
    Perera KMH, Tulley M, Jenner FA (1987). The use of benzodiazepines among drug addicts. Br J Addict82:511–515.PubMedCrossRefGoogle Scholar
  40. 40.
    Schuster CL, Humphries RH (1981). Benzodiazepine dependency in alcoholics. Conn Med45 (1): 11–13.PubMedGoogle Scholar
  41. 41.
    Cappell H, Busto U, Kay G (1987). Drug deprivation and reinforcement by diazepam in a dependent population. Psychopharmacology91:154–160.PubMedCrossRefGoogle Scholar
  42. 42.
    American Psychiatric Association (1987). Psychoactive Substance Use Disorders. In Diagnostic and Statistical Manual of Mental Disorders, 3d Ed. (revised ), pp. 165–186. Washington, DC: American Psychiatric Association.Google Scholar
  43. 43.
    Busto U, Sellers EM (1986). Pharmacokinetic determinants of drug abuse and dependence: A conceptual perspective. Clin Pharmacokinet11:144–153.PubMedCrossRefGoogle Scholar
  44. 44.
    Perry PJ, Alexander B (1986). Sedative/hypnotic dependence: Patient stabilization, tolerance testing and withdrawal. Drug Intell Clin Pharm20:532–536.PubMedGoogle Scholar
  45. 45.
    Harrison M, Busto U, Naranjo CA (1984). Diazepam tapering in detoxification for high-dose benzodiazepine abuse. Clin Pharmacol Ther36 (4): 527–533.PubMedCrossRefGoogle Scholar
  46. 46.
    Griffiths RR, Bigelow GE, Liebson I (1983). Differential effects of diazepam and pentobarbital on mood and behavior. Arch Gen Psychiatry40:865–873.PubMedGoogle Scholar
  47. 47.
    Chan AWK (1984). Effects of combined alcohol and benzodiazepine: A review. Drug A Icohol Depend13:315–341.CrossRefGoogle Scholar
  48. 48.
    Miller NS, Mirin SM (1989). Multiple drug use in alcoholics: Practical and theoretical implications. Psychiatr Ann19 (5): 248–255.Google Scholar
  49. 49.
    Greenblatt DJ, Shader RI, Divoll M, et al. (1981). Benzodiazepines: A summary of pharmacokinetic properties. Br J Clin Pharmacol (Suppl) 11:11S–16S.Google Scholar
  50. 50.
    Perry PJ, Alexander B (1986). Sedative/hypnotic dependence: Patient stabilization, tolerance, testing and withdrawal. Drug Intell Clin Pharm20:532–536.PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York 1991

Authors and Affiliations

  • Norman S. Miller
    • 1
  1. 1.Cornell University Medical CollegeNew York Hospital-Cornell Medical CenterUSA

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