Dependence liability of the benzodiazepines.

According to pharmacological data as well as to clinical experience a potential of benzodiazepines for producing dependence is not a matter of doubt. However, when compared to the dependence liability of barbiturates the corresponding effect of benzodiazepines is low. In evaluating the dependence potential of benzediazepines account must be taken of the rareness of psychotropic effects of these substances and of the absence of usual mechanisms of tolerance, as well as the epidemiology of psychosomatic syndromes and their treatment outcome. The paper summarizes different types of clinical approaches to evaluating the abuse and dependence liability. In relation to the high incidence of prescriptions for benzodiazepines, the incidence of dependence syndromes is low, but with a wide range of degrees and patterns of such syndromes. Mostly autonomic and psychic symptoms, occasionally grand mal seizures and sensory disturbances and very rarely psychotic symptoms have been described. While the time course differs there is, in comparison to barbiturates, a shift in onset and duration of symptoms.