Taylor F K
Bethlem Royal Hospital, London.
Br J Psychiatry. 1989 May;154:697-704. doi: 10.1192/bjp.154.5.697.
It is argued that there are two kinds of benzodiazepine dependence: a therapeutic and a morbid kind. The therapeutic dependence is acceptable in that it mitigates the clinical manifestations in patients with long-standing and fluctuating anxious-depressive symptoms. The morbid dependence is an unfortunate complication which can arouse therapeutic concern because it ties patients to an excessive dosage, unless the penalty of a sometimes grim abstinence syndrome is paid on drug reduction. The present, often strident and threatening, damnation of benzodiazepines oversteps the mark and causes avoidable misery to patients whose well-being has become largely and therapeutically dependent on the drug.
有人认为存在两种苯二氮䓬类药物依赖:一种是治疗性依赖,另一种是病态依赖。治疗性依赖是可以接受的,因为它能减轻长期存在且波动的焦虑抑郁症状患者的临床表现。病态依赖则是一种不幸的并发症,它会引发治疗上的担忧,因为它使患者依赖过量用药,除非在减少用药时承受有时很严重的戒断综合征的代价。目前对苯二氮䓬类药物的谴责往往尖锐且带有威胁性,有些过头了,给那些健康在很大程度上且在治疗上依赖该药物的患者造成了不必要的痛苦。