Serfaty M, Masterton G
Department of Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne.
Br J Psychiatry. 1993 Sep;163:386-93. doi: 10.1192/bjp.163.3.386.
The fatal toxicity indices of benzodiazepines during the 1980s were calculated from national prescribing data and mortality statistics. The overall rate was 5.9 deaths per million prescriptions for benzodiazepines taken alone or with alcohol only, anxiolytics being less toxic than hypnotics. Diazepam appeared more toxic than average among anxiolytics (P < 0.05), and flurazepam and temazepam more toxic than average among hypnotics (both P < 0.001). It was shown that the finding for diazepam was probably explained by concurrent use of alcohol, which implies that other anxiolytics may be safer in cases where there is alcohol misuse; but the greater toxicity of flurazepam and temazepam remained unexplained. Benzodiazepines are indeed much less toxic than the barbiturates they superseded, but they are not innocuous and temazepam in particular requires further evaluation.
20世纪80年代，苯二氮䓬类药物的致死毒性指数是根据全国处方数据和死亡率统计计算得出的。单独服用苯二氮䓬类药物或仅与酒精同时服用时，总体死亡率为每百万张处方5.9例死亡，抗焦虑药的毒性低于催眠药。在抗焦虑药中，地西泮的毒性似乎高于平均水平（P < 0.05），在催眠药中，氟西泮和替马西泮的毒性高于平均水平（均为P < 0.001）。结果表明，地西泮的这一发现可能是由同时饮酒所致，这意味着在存在酒精滥用的情况下，其他抗焦虑药可能更安全；但氟西泮和替马西泮毒性较大的原因仍无法解释。苯二氮䓬类药物的毒性确实比它们所取代的巴比妥类药物低得多，但它们并非无害，尤其是替马西泮需要进一步评估。
