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苯二氮䓬类药物。

Benzodiazepines.

作者信息

Nielsen Suzanne

机构信息

National Drug and Alcohol Research Centre, UNSW, 22-32 King Street, Randwick, NSW, 2031, Australia.

South East Sydney Local Health District (SESLHD) Drug and Alcohol Services, 591-623 S Dowling St, Surry Hills, NSW, 2010, Australia.

出版信息

Curr Top Behav Neurosci. 2017;34:141-159. doi: 10.1007/7854_2015_425.

Abstract

Benzodiazepines have been in clinical use since the 1960s. Benzodiazepines act through allosteric modulation of the GABA receptor to enhance the activity of GABA, an inhibitory neurotransmitter, resulting in a slowing of neurotransmission and sedative and anxiolytic effects. Initially benzodiazepines were thought to have low dependence liability, though over time there has been increasing evidence of benzodiazepine dependence. Benzodiazepines are commonly used to treat anxiety and insomnia, though increasingly they are considered second line treatments for most indications. Concerns about the effects of benzodiazepines on cognition, falls and their implication in opioid related mortality have emerged. Few pharmacological treatments for benzodiazepine dependence have been shown to be effective with gradual taper the most common treatment strategy for benzodiazepine dependence.

摘要

自20世纪60年代以来,苯二氮䓬类药物一直在临床中使用。苯二氮䓬类药物通过对γ-氨基丁酸(GABA)受体的变构调节来发挥作用,增强GABA(一种抑制性神经递质)的活性,从而导致神经传递减慢以及产生镇静和抗焦虑作用。最初,人们认为苯二氮䓬类药物产生依赖性的可能性较低,不过随着时间的推移,越来越多的证据表明存在苯二氮䓬类药物依赖现象。苯二氮䓬类药物通常用于治疗焦虑和失眠,尽管在大多数适应症中它们越来越被视为二线治疗药物。人们已经开始关注苯二氮䓬类药物对认知、跌倒的影响以及它们在阿片类药物相关死亡率中的作用。很少有针对苯二氮䓬类药物依赖的药物治疗被证明是有效的,逐渐减量是治疗苯二氮䓬类药物依赖最常见的治疗策略。

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