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苯二氮䓬类药物:用途、风险及临床考量

Benzodiazepines: Uses, Dangers, and Clinical Considerations.

作者信息

Edinoff Amber N, Nix Catherine A, Hollier Janice, Sagrera Caroline E, Delacroix Blake M, Abubakar Tunde, Cornett Elyse M, Kaye Adam M, Kaye Alan D

机构信息

Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA.

School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA.

出版信息

Neurol Int. 2021 Nov 10;13(4):594-607. doi: 10.3390/neurolint13040059.

Abstract

Benzodiazepines (BZDs) are among one of the most widely prescribed drug classes in the United States. BZDs are a class of psychoactive drugs known for their depressant effect on the central nervous system (CNS). They quickly diffuse through the blood-brain barrier to affect the inhibitory neurotransmitter GABA and exert sedative effects. Related to their rapid onset and immediate symptom relief, BZDs are used for those struggling with sleep, anxiety, spasticity due to CNS pathology, muscle relaxation, and epilepsy. One of the debilitating side effects of BZDs is their addictive potential. The dependence on BZDs generally leads to withdrawal symptoms, requiring careful tapering of the medication when prescribed. Regular use of BZDs has been shown to cause severe, harmful psychological and physical dependence, leading to withdrawal symptoms similar to that of alcohol withdrawal. Some of these withdrawal symptoms can be life threatening. The current treatment for withdrawal is through tapering with clonazepam. Many drugs have been tested as a treatment for withdrawal, with few proving efficacious in randomized control trials. Future research is warranted for further exploration into alternative methods of treating BZD withdrawal. This call to action proves especially relevant, as those seeking treatment for BZD dependence and withdrawal are on the rise in the United States.

摘要

苯二氮䓬类药物(BZDs)是美国处方量最大的药物类别之一。BZDs是一类精神活性药物,以其对中枢神经系统(CNS)的抑制作用而闻名。它们能迅速穿过血脑屏障,影响抑制性神经递质γ-氨基丁酸(GABA)并发挥镇静作用。由于起效迅速且能立即缓解症状,BZDs被用于治疗睡眠问题、焦虑症、因中枢神经系统病变引起的痉挛、肌肉松弛以及癫痫。BZDs令人衰弱的副作用之一是其成瘾潜力。对BZDs的依赖通常会导致戒断症状,因此在开药时需要谨慎逐渐减少用药剂量。长期使用BZDs已被证明会导致严重的有害心理和身体依赖,引发与酒精戒断类似的戒断症状。其中一些戒断症状可能会危及生命。目前针对戒断的治疗方法是通过逐渐减少氯硝西泮的用量。许多药物都曾被测试用于治疗戒断,但在随机对照试验中证明有效的很少。有必要进行进一步的研究,以探索治疗BZD戒断的替代方法。这一行动呼吁尤为重要,因为在美国,寻求BZD依赖和戒断治疗的人数正在上升。

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