Perry P J, Alexander B
Drug Intell Clin Pharm. 1986 Jul-Aug;20(7-8):532-7. doi: 10.1177/106002808602000702.
Physical dependence to sedative/hypnotic drugs is not an uncommon clinical problem. The withdrawal syndrome is analogous to alcohol withdrawal, except the duration of the syndrome occurs over a longer period of time with the symptoms being less intense than generally encountered with alcohol. The potential for withdrawal reactions is probably greater for the shorter-acting agents than the longer-acting drugs. Potentially dependent sedative/hypnotic users require stabilization of their symptoms initially, followed by tolerance testing. If tolerant, the patients should be withdrawn using either a long-acting sedative/hypnotic (e.g., diazepam) or phenobarbital. Compared to other benzodiazepines and barbiturates, diazepam appears to be the drug of choice for treating dependent patients. Diazepam is rapidly absorbed and distributed to the brain and therefore useful for stabilization and tolerance testing. It is metabolized on chronic administration to a long-acting metabolite, desmethyldiazepam, which makes the drug ideal for a tapered withdrawal schedule.
对镇静催眠药物产生身体依赖是一个并不罕见的临床问题。戒断综合征与酒精戒断相似，只是该综合征持续时间更长，症状强度比酒精戒断时通常遇到的要轻。短效药物比长效药物发生戒断反应的可能性可能更大。有潜在依赖性的镇静催眠药物使用者最初需要稳定症状，随后进行耐受性测试。如果有耐受性，患者应使用长效镇静催眠药物（如地西泮）或苯巴比妥进行撤药。与其他苯二氮䓬类药物和巴比妥类药物相比，地西泮似乎是治疗依赖患者的首选药物。地西泮吸收迅速并分布到大脑，因此可用于症状稳定和耐受性测试。长期给药时，它会代谢为长效代谢物去甲地西泮，这使得该药物非常适合逐渐减量的撤药方案。
