Introduction to benzodiazepines psychopharmacolgy

1. Benzodiazepines (BZDs)
Dr Ahmad Eid, MBChB MScMed
Board-certified in psychiatry
Director of Abbassia Training Program (ATP)

2. Place of BZDs in psychotropics
 In clinical practice since 1961
 Commonly prescribed: 10 %
population / year
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3. Drug-grouping of BZDs
 Sedative-hypnotics
 Anxiolytics
 Antiepileptics
 Muscle relaxants
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4. Available in Egypt: EDA Sep 2011
1. Alprazolam (Xanax): 0.25, 0.5, 1, 2 , 3 tab
2. Bromazepam (Calmepam): 1.5, 3 tab
3. Clordiazepoxide (incl. Librax): 10 tab
4. Clonazepam (Apetryl): 0.5, 2 tab 2.5 mg/ml
oral drops
5. Diazepam (Neuril): 2, 5 tab, 2 mg/5ml syr, 5
mg/ml inj
6. Midazolam (Dormicum): 5 mg/ml inj, 7.5 tab
7. Oxazepam (Comedormir): 10, 15 tab
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5. GABAA receptor
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6. GABAA receptor
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7. Major Metabolic Relationships among Some of the Benzodiazepines
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8. Hepatic metabolism of BZDs
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9. BZDs Withdrawal syndrome
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10. Clinical indications
 Anxiety ds
 Insomnia: Not first line, 3 – 5 ds
 Augmenting antidepressants
/antipsychotics / mood stabilizers: in
acute phase
 Epilepsy, muscle spasm and pre
anesthetic
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11. Clinical precautions
 Short prescription: 2 – 4 wks
 Avoid in pts of COPD, elderly
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12. Related to BZDs
 As sedative-hypnotics: Z drugs,
Melatonin agonist, and Barbs
 As anxiolytics: buspirone
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