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Other psychomotor effects, such as problems with coordination and delayed

reaction time, can also occur during benzodiazepine treatment.

23 These effects are

also dose-related, but usually subside within a few weeks of continued treatment.

Long-acting benzodiazepines taken the previous night may cause residual daytime

effects, which can result in car accidents and hospitalization in older individuals

receiving these medications.

62

The link between benzodiazepine use and falls, especially in the elderly, is well

documented.

63 Rapid dosage escalation and use of high doses have been identified as

major risk factors, but even use of low doses of short-acting agents greatly increases

the risk of falling in the elderly.

63–65

Respiratory depression is another potential adverse effect of benzodiazepines, but

it is usually clinically relevant only in patients with severe respiratory disease, in

overdose situations (see Case 83-5, Question 1), or when combined with alcohol or

substances that depress breathing, like opioids. It is recommended that

benzodiazepines be avoided in patients with sleep apnea.

p. 1741

p. 1742

Respiratory complications are encountered most often with IV administration.

Severe respiratory depression has also occurred with the concurrent use of

benzodiazepines and olanzapine IM (Zyprexa), loxapine (Loxitane), or clozapine

(Clozaril). Further, it should be noted benzodiazepines increase the risk of death in

prescription drug overdoses, typically in combination with other medications or

drugs of abuse.

66

Paradoxical disinhibition, with increased anxiety, irritability, and agitation, can

occur infrequently with benzodiazepines,

23 primarily in elderly or developmentally

disabled individuals.

67 Other unusual behaviors, such as increased anger, hostility,

depression, suicidal ideation, and rage, have been attributed to benzodiazepine use in

a small number of cases.

23,68 Most of these reports were anecdotal and involved

patients with preexisting psychiatric disorders such as bipolar disorder or

schizophrenia. Overall, there is no convincing evidence that benzodiazepines actually

cause violent or suicidal behaviors, but there is some evidence to the contrary.

23,67

In summary, L.V. should be told he may experience sedation and difficulties in

thinking, concentration, or memory during the first week or so of therapy, but these

side effects should resolve once he experiences some tolerance to the drug. He

should be extremely careful while driving or performing other tasks requiring

psychomotor skills, especially during the first week, and he should avoid the use of

alcohol while he is taking benzodiazepines.

BENZODIAZEPINE ABUSE AND DEPENDENCE

CASE 83-2, QUESTION 5: Two weeks later, L.V. contacts his clinician to discuss a medication concern.

He reports the medication has been extremely effective in relieving his anxiety, and he is currently taking

paroxetine 20 mg every morning and alprazolam, 0.25 mg TID, as directed by his physician. However, his friend

has told him he will become addicted to alprazolam, and he wonders whether he should stop taking it because of

this concern. What potential for abuse and dependence is associated with benzodiazepines? How should L.V.

be counseled regarding “becoming addicted” to alprazolam?

Concerns related to abuse and dependence are one major drawback to the clinical

use of benzodiazepines. These agents are classified as schedule IV controlled

substances. Diazepam, alprazolam, and lorazepam are more likely to be abused than

are oxazepam and chlordiazepoxide.

69 This difference is commonly attributed to the

quicker onset of effect and high potency which may be associated with a subjective

euphoric sensation. The XR alprazolam formulation is reported to have a lower

abuse potential than immediate-release alprazolam because of its slower onset of

effect smaller peak to trough ratio and lower maximal plasma concentrations.

56

Patients without a history of substance abuse who take benzodiazepines for

therapeutic purposes are unlikely to escalate doses or use them in ways characteristic

of abuse.

69

The potential problems with benzodiazepine abuse and dependence can be

avoided or minimized in several ways. First is the identification of patients who have

a history of alcohol or substance abuse and using nonbenzodiazepine treatments in

such cases.

69 Second, patients should be counseled about the anticipated duration of

benzodiazepine use, the possibility of withdrawal symptoms, and the importance of

gradual drug tapering when therapy is discontinued. The distinction between

“addiction” and appropriate therapeutic use, which may be accompanied by some

degree of physical dependence, should be explained.

L.V. should be advised that as long as the medication is helping his anxiety and he

is taking it according to his physician’s instructions, his use of alprazolam does not

constitute addiction. However, his body may develop some physiologic dependence

to the drug, so if he stops taking alprazolam abruptly, he could experience increased

anxiety and other withdrawal symptoms. When alprazolam is to be discontinued, the

dose should be decreased gradually for a sufficient period to minimize withdrawal

symptoms.

DURATION OF TREATMENT

CASE 83-2, QUESTION 6: Two weeks later at his clinic appointment, L.V. is still doing well and has shown

further improvements in his GAD symptoms. He has been taking the prescribed alprazolam and paroxetine for

1 month, and his paroxetine has been increased to 40 mg/day during this time. How long should medication

therapy continue?

GAD is a chronic disorder fluctuating in severity and often requires long-term

treatment. Although long-term use of benzodiazepines can be safe and effective, it is

desirable to limit treatment to the shortest duration necessary.

20,22,25 When

benzodiazepines are used for acute anxiolytic effects during initiation of

antidepressant treatment for GAD, they are commonly limited to short-term (2–6

weeks) therapy. L.V. has demonstrated good response after 1 month of combined

alprazolam and paroxetine therapy. Because the anxiolytic effects of paroxetine

usually occur between 2 and 4 weeks of therapy and he is taking a therapeutic

paroxetine dose, it is appropriate to start discontinuing alprazolam at this time. While

it is unlikely, L.V. may experience significant withdrawal symptoms even after only 1

month of treatment; thus, the dose should be gradually decreased for several weeks,

according to tolerability of the taper.

70

In patients who are treated with short-acting

benzodiazepines for longer durations, switching to an equivalent dose of a longeracting benzodiazepine, like diazepam, may simplify the withdrawal schedule.

71

There is no consensus about the optimal duration of drug therapy for GAD.

However, recent recommendations suggest effective medication treatment be

continued for at least 6 to 12 months after response.

22,72 Continuation treatment with

antidepressants significantly reduces the risk of GAD relapse in 6 months.

73

Therefore, paroxetine therapy should be continued for another 5 to 11 months in

L.V.’s case. After that time, gradual paroxetine discontinuation may be considered,

and reinstitution of treatment is warranted if relapse occurs.

SYMPTOMS AND MANAGEMENT OF BENZODIAZEPINE WITHDRAWAL

CASE 83-3

QUESTION 1: T.B., a 48-year-old woman, has been taking diazepam 20 mg BID for 7 months for its muscle

relaxant effects after sustaining back and other injuries from a collision with her road bike and an automobile.

Five days ago, T.B. was unable to refill her prescription for financial reasons. A brief mental status examination

reveals mild confusion and irritability. Physically, T.B. is trembling and complains of nausea and insomnia. Her

medical history indicates no current medical problems or psychiatric illnesses, and T.B. denies the use of

tobacco, alcohol, or other drugs of abuse. How should T.B. be treated?

Because T.B. has not taken her prescribed diazepam for five days, it is likely she

is experiencing a withdrawal syndrome from long-term benzodiazepine use. Her

mental and physical symptoms are consistent with benzodiazepine withdrawal. The

benzodiazepine withdrawal syndrome implies some degree of physical dependence,

and its onset, duration, and severity can vary according to dose, duration of treatment,

speed of withdrawal, and elimination half-life of the agent used.

69,70 Withdrawal

symptoms that follow discontinuation of agents with short half-lives usually appear

within 1 to 2 days and may be more intense and short-lived than after discontinuation

of long-acting benzodiazepines. Withdrawal symptoms usually appear 4 to 7 days

after discontinuation of long-acting agents and may last several weeks. Symptoms of

benzodiazepine withdrawal, which are listed in Table 83-7, are generally mild when

the drug is tapered gradually during discontinuation.

70 Rarely, serious symptoms such

as seizures or psychosis may occur during benzodiazepine withdrawal. Risk factors

for seizures include head injury, alcohol dependence, electroencephalogram

abnormalities, and use of other drugs that lower the seizure threshold.

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p. 1743

Table 83-7

Symptoms of Benzodiazepine Withdrawal

Common Less Common Rare

Anxiety Nausea Confusion

Insomnia Depression Delirium

Irritability Ataxia Psychosis

Muscle aches or weakness Hyperreflexia Seizures

Tremor Blurred vision Catatonia

Loss of appetite Fatigue

Diazepam 10 to 20 mg orally should be administered and repeated within 1 to 2

hours if needed. Resumption of her previous diazepam dosage of 40 mg/day should

effectively treat her withdrawal symptoms. However, because her acute injury

occurred 7 months ago, it may be desirable to begin tapering diazepam.

Various dosage reduction regimens have been proposed for benzodiazepine

discontinuation. Even when managing withdrawal from low-dose benzodiazepine

use, doses should be reduced slowly for 4 to 16 weeks.

70 The rate of the drug taper

should be individualized to the patient, but a general recommendation is a 10% to

25% decrease in the dosage every 1 to 2 weeks. The first half of the benzodiazepine

taper (down to 50% of the original dose) is generally easier and can proceed more

quickly than the last half of the taper.

70

In T.B.’s case, the discontinuation period may

take several months.

In general, the same benzodiazepine the patient has been taking should be used to

manage withdrawal. However, because withdrawal symptoms are more severe

during discontinuation of short-acting compared with long-acting benzodiazepines, a

long-acting agent can be substituted at an equivalent dosage and then tapered.

70,71

In

difficult cases, adjunctive medications, such as anticonvulsants, like carbamazepine

or phenobarbital, or propranolol, have been used to ease tolerability of the gradual

withdrawal, though the latter does not affect the associated anxiety or decrease the

seizure risk.

70,74

BENZODIAZEPINE DRUG INTERACTIONS

CASE 83-4

QUESTION 1: N.P., a 20-year-old female college student, has been taking alprazolam 1 mg TID PRN for

treatment of GAD for the past 2 months. She states alprazolam has been very helpful for her GAD, but

complains to her physician she is feeling especially stressed. She is having trouble balancing the increased

workload of higher-level courses with her social life, which includes a new relationship. She has no medical

illnesses, but states she has suffered from several episodes of heartburn recently, which may be stress-related.

She is also interested in starting an oral contraceptive. N.P. smokes two packs of cigarettes per day and drinks

up to three 12-ounce caffeinated sodas per day. An oral contraceptive (Yaz) is prescribed, and ranitidine is

recommended for treatment of heartburn. What potential drug interactions with alprazolam are present in this

case?

The most significant pharmacodynamic drug interactions involve other CNS

depressants such as alcohol or barbiturates. These combinations can lead to additive

CNS and respiratory depressant effects that can be deadly. Important

pharmacokinetic drug interactions mainly involve agents that either inhibit or induce

benzodiazepine metabolism.

75 One clinically significant drug interaction occurs with

the use of azole antifungals in combination with benzodiazepines. Azole antifungals

are potent CYP3A4 inhibitors that can cause a 170% increase in the area under the

curve of alprazolam.

76 Therefore, the dosage of alprazolam should be reduced by

about one-third in patients receiving this combination. Since benzodiazepines have a

relatively wide margin of safety, elevated plasma levels or prolonged elimination

half-lives are unlikely to cause serious toxicity. However, they can lead to increased

sedative and psychomotor effects, which may be clinically significant in certain

cases. Conversely, increased benzodiazepine metabolism by hepatic enzyme inducers

may result in medication ineffectiveness. Most pharmacokinetic drug interactions

with benzodiazepines involve CYP3A4- or CYP2C19-mediated mechanisms. Please

refer to a drug interactions database, such as Facts & Comparisons

(http://www.wolterskluwercdi.com/) for additional information.

In N.P.’s case, the most important drug interaction is between alprazolam and the

newly prescribed oral contraceptive, Yaz. Estrogen-containing oral contraceptives

can inhibit the CYP3A4 metabolism of benzodiazepines such as alprazolam,

potentially resulting in increased side effects.

77,78 Thus, a reduction in the

benzodiazepine dosage may be needed when oral contraceptives are added to

ongoing benzodiazepine therapy, as in N.P.’s case. The clearance of benzodiazepines

that undergo glucuronidation (lorazepam, oxazepam, and temazepam) can be

accelerated by oral contraceptives, but this interaction is probably clinically

insignificant.

57,77

Cigarette smoking increases the clearance of some benzodiazepines (clorazepate,

lorazepam, oxazepam), but has no effect on others (diazepam, midazolam,

chlordiazepoxide).

79 Overall, the effect of smoking is unpredictable and is most

likely to be important in patients who either stop or start smoking while taking a

benzodiazepine. N.P. should be urged to quit smoking for the sake of her general

health and to prevent substantial risks for serious cardiovascular events occurring in

smokers taking oral contraceptives. If N.P. does quit, careful monitoring will be

needed to determine whether any alprazolam dosage reduction is necessary.

N.P. should also be encouraged to decrease her soda consumption because

caffeine can increase anxiety, thus decreasing the effectiveness of alprazolam.

Caffeine has been shown to decrease diazepam concentrations by approximately

22%, but studies with other benzodiazepines are lacking.

75

BENZODIAZEPINE USE IN PREGNANCY AND LACTATION

CASE 83-4, QUESTION 2: At her clinic visit 2 years later, N.P. is doing very well. She has graduated from

college, is happily married, and states she and her husband have decided to start a family. N.P. has discontinued

her oral contraceptive in hopes of becoming pregnant soon and has successfully quit smoking. N.P.

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continues to take alprazolam 0.5 mg twice daily (BID) to TID as needed and wonders whether she should also

stop taking this drug before she becomes pregnant. What is the teratogenic potential of alprazolam? What

alternative treatments are available for the management of N.P.’s anxiety?

Early reports implicated diazepam in causing several birth deformities, including

cleft lip or cleft palate and limb and digit malformations, but later studies failed to

support this association.

80–84 Most benzodiazepine anxiolytics are classified as

pregnancy category D (however, this language will be modified once the FDA

labeling changes for pregnancy and lactation go into effect), indicating there is some

evidence of fetal risk but the benefits of the medication may outweigh these risks in

certain patients.

80,82 Available evidence suggests benzodiazepine use during the first

trimester increases the risk for oral clefts by approximately 2.4-fold, but the absolute

risk is increased only 0.01%. Benzodiazepines have not exhibited strong teratogenic

effects, but it is always advisable to avoid drug use during pregnancy when possible,

especially in the first trimester.

82,84

In patients such as N.P., the benzodiazepine

should be tapered and discontinued before she becomes pregnant. Nondrug treatments

for her GAD such as relaxation therapy, meditation, biofeedback, or cognitive

therapy may be helpful. If necessary, single or repeated small doses of

benzodiazepines during the second and third trimesters are unlikely to have important

adverse effects on the fetus. In these instances, an agent with a short half-life, such as

lorazepam, should be considered.

84 Chronic or large doses, especially of long-acting

agents, should be avoided because they may accumulate in the fetus. Perinatal

sequelae in newborns of mothers who took benzodiazepines during pregnancy

include withdrawal symptoms, sedation, muscle weakness, hypotonia, apnea, poor

feeding, low birth weight, and increased risk for preterm birth.

81,85

The clinical situation of unexpected pregnancy in a woman maintained on

benzodiazepines can also arise. The general course of action in such cases is often to

discontinue all medications immediately. However, it is unwise to abruptly stop

benzodiazepine treatment in someone who has been receiving chronic therapy

because the resultant withdrawal syndromes can be detrimental to both mother and

child. Benzodiazepine dosages should be tapered as quickly as possible to the lowest

dosage necessary and discontinued if possible. The postpartum period is a time of

heightened risk for recurrence of anxiety disorders, and new mothers should be

monitored carefully for signs of relapse.

86 Benzodiazepines are excreted readily in

breast milk, and they should be avoided by nursing mothers, when possible, but use is

not absolutely contraindicated.

87

If benzodiazepines are used, short-acting agents with

no active metabolites are recommended to avoid sedation, poor feeding, withdrawal,

and other effects in the infant.

81,88

BENZODIAZEPINE OVERDOSE AND USE OF FLUMAZENIL

CASE 83-5

QUESTION 1: S.P. is a 17-year-old young man who is brought to the hospital by his mother. S.P. is barely

conscious, and his breathing is slow and shallow. His mother states he “took a whole bottle of diazepam” (5 mg,

30 pills) some time during the previous night. S.P.’s medical history is significant for a severe head injury

sustained from a car accident 8 months ago. He currently takes carbamazepine (Tegretol) 200 mg TID for

seizure prophylaxis. S.P.’s mother believes diazepam is the only drug he ingested because no other medications

are missing. Toxicology is positive for benzodiazepines and negative for other substances. What signs and

symptoms are consistent with benzodiazepine overdose? Why is it inappropriate to administer the

benzodiazepine antagonist, flumazenil, in this case?

Benzodiazepine overdose is characterized by respiratory and CNS depression,

both of which are evident in this case (S.P. is almost unconscious, with slow and

shallow breathing). Overdose with benzodiazepines as the sole ingested agent is

rarely life-threatening, and full recovery is the usual outcome.

89 Flumazenil is a

benzodiazepine receptor antagonist effective in reversing sedation associated with

benzodiazepine intoxication. Its effects on respiratory depression are inconsistent,

but improved breathing may occur secondarily to increased consciousness.

89

The primary use of flumazenil is in reversing benzodiazepine-induced conscious

sedation (primarily with midazolam) in patients who have been sedated for minor

surgical or diagnostic procedures. Flumazenil is also approved for treating

benzodiazepine overdose, but this use is controversial because of potentially serious

complications (e.g., supraventricular arrhythmia and seizure), and questions about its

cost-effectiveness.

90,91 Flumazenil administration does not appear to decrease

mortality or length of hospital stay in cases of benzodiazepine overdose; therefore, its

use for this purpose has become limited.

90

Flumazenil is contraindicated in overdoses of any agent that decreases the seizure

threshold, such as TCAs. Toxicology screening and an electrocardiogram (ECG)

should be performed before flumazenil is administered. Because of a risk of seizures,

flumazenil should also be avoided in patients with increased intracranial pressure or

a known history of seizures or head injury, in those who have been receiving chronic

benzodiazepine therapy, and in patients with a history of recent illicit drug abuse

(cocaine, heroin). Administration of flumazenil should occur only when acute seizure

management measures are available.

Flumazenil reverses benzodiazepine-induced sedation or coma within 1 to 2

minutes after IV administration. The most common side effects include agitation,

dizziness, nausea, general discomfort, tearfulness, anxiety, and a sensation of

coldness.

89 Rapid or excessive infusion has been associated with tachycardia and

hypertension. The elimination half-life of flumazenil is 41 to 79 minutes, and sedation

may recur after 1 to 2 hours, especially when large doses of long-acting

benzodiazepines are involved. Repeated flumazenil doses or an IV infusion may be

indicated in these cases. Full recovery should be verified (3–4 hours of stable

alertness) before patients are discharged after flumazenil administration, and they

should be advised to avoid driving or performing other potentially hazardous

activities for 24 hours. Flumazenil undergoes extensive hepatic metabolism to its

glucuronide conjugate and de-ethylated free acid. Dosage reductions are

recommended in patients with liver dysfunction.

Flumazenil is not appropriate in S.P.’s case because of his history of head injury

and risk of post-traumatic seizures. Instead, management should involve general

supportive measures and mechanical ventilation, if indicated. A psychiatric

evaluation is also indicated in this case to identify and address the reasons for S.P.’s

overdose.

PHYSIOLOGIC VARIABLES INFLUENCING BENZODIAZEPINES

CASE 83-6

QUESTION 1: B.G., a 68-year-old man, is brought to the emergency department (ED) by his wife after being

involved as the driver in a minor car accident. He has no physical injuries except for several small abrasions

caused by the car airbag deployment. However, B.G. appears drowsy, is mildly confused, and has an unsteady

gait. A toxicology screen reveals no alcohol or other substances, except for clonazepam, which his physician

prescribed several months ago. B.G.’s wife states he has been taking 0.5 mg BID, and it has been remarkably

effective in improving his mood and anxiety. B.G., who is 5 feet 8 inches tall and weighs 250 pounds, is a

recovering alcoholic with moderate liver disease caused by years of heavy drinking. He has successfully

maintained his sobriety for nearly 2 years. In addition to clonazepam, B.G. also occasionally takes OTC

omeprazole and cimetidine for heartburn. It is determined B.G. is experiencing adverse effects of clonazepam,

probably caused by drug accumulation. What factors could be influencing disposition of clonazepam in this

patient?

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Table 83-8

Physiologic Factors Influencing Benzodiazepine Pharmacokinetics

Factor Physiologic and Pharmacokinetic Effects Clinical Significance or Comments

Aging Increased elimination half-life as a result of

increased Vd of all benzodiazepines

92

Lower benzodiazepine dosages, and possibly less

frequent dosing intervals, recommended in the

elderly

Decreased clearance of benzodiazepines that

undergo oxidative hepatic metabolism (Table 83-

6)

93

Benzodiazepines that undergo glucuronidation

(lorazepam, oxazepam) preferred in the elderly

Decreased plasma proteins may lead to increased

free fraction of highly protein-bound

benzodiazepines (Table 83-6)

Possible increased clinical effects

Decreased gastric acidity may lead to increased

rate of benzodiazepine absorption

Possible faster onset of clinical effects

Sex Age-related decrease in hepatic oxidative

metabolism of benzodiazepines more pronounced

in men

Elderly men may require especially low

benzodiazepine dosages

Increased CYP 3A4 and CYP 2C19 activity in

premenopausal women may result in higher

clearance of drugs that undergo oxidative

metabolism

77

Possible decreased plasma benzodiazepine

concentrations and shorter duration of clinical

effects of oxidatively metabolized agents in

premenopausal women

Decreased glucuronidation in women may result

in slower clearance of benzodiazepines

metabolized by conjugation

77

Women may have longer elimination half-lives of

lorazepam and temazepam and may require lessfrequent dosing

Increased Vd in women owing to lower lean body

mass and increased adipose tissue

77

Possible longer elimination half-lives in women,

especially the elderly, and greater drug

accumulation

Lower plasma protein binding in women

77 Clinicalsignificance unknown

Obesity Increased benzodiazepine elimination half-lives

owing to increased Vd

Increased chance of drug accumulation in obese

patients; dosage reductions may be indicated

Liver

disease

Decreased clearance and increased elimination

half-lives of long-acting benzodiazepines and

alprazolam in cirrhosis and hepatitis; no changes

with oxazepam or triazolam

57

Avoid long-acting benzodiazepines, or use

significantly lower doses to avoid drug

accumulation

Increased elimination half-life of lorazepam in

cirrhosis but not acute hepatitis

Decreased lorazepam dose or increased dosing

interval recommended in cirrhosis

Kidney

disease

Decreased plasma protein binding may lead to

increased free fraction of highly protein-bound

benzodiazepines (Table 83-6)

94

Dosage reductions may be necessary

Ethnicity Decreased oxidative metabolism (via CYP 2C19)

of diazepam and alprazolam in Asians

95

Asians may require lower doses of diazepam,

alprazolam, and possibly other benzodiazepines

CYP, cytochrome P-450; Vd, volume of distribution.

Benzodiazepine pharmacokinetics can be affected by various physiologic factors,

listed in Table 83-8.

57,77,92–95 Several of these factors are present in this case and may

have contributed to the accumulation of clonazepam with resulting adverse

consequences.

B.G.’s age may influence clonazepam disposition. Reductions in both CYP3A4

and CYP2C19 activity have been reported to occur with aging. The glucuronidation

metabolic pathways are minimally affected with age, so no such effect is seen with

lorazepam or oxazepam.

57 Other factors contributing to longer benzodiazepine half-

lives in the elderly include decreased hepatic blood flow and increased volumes of

distribution of lipid-soluble compounds (owing to decreased muscle mass and

increased fat); the latter can increase a drug’s half-life in the absence of any

clearance changes. As described in Case 83-3, Question 4, older patients are more

sensitive to the sedative and psychomotor and especially cognitive impairing effects

of benzodiazepines. For these reasons, benzodiazepines should be avoided in the

elderly but if necessary, then the recommended benzodiazepine dosages for patients

older than 65 years are generally one-third to one-half of those used in healthy adults

(Table 83-4).

Sex also may influence benzodiazepine clearance, but studies yield mixed

results.

77,96,97 Women have been reported to have higher CYP3A4 and CYP2C19

activities than men, which may partially explain these findings. Increased CYP3A4

activity in

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