Abstract
The first discovered benzodiazepine (chlordiazepoxide) was developed serendipitously by Leo Henryk Sternbach working for the Hoffmann-LaRoche Inc. in 1955 and made available as Librium in 1955. Benzodiazepines are often classified by duration of action and this chapter will review intermediate acting Alprazolam, Bromazepam, Clonazepam, and Lorazepam. These drugs are metabolized by the hepatic Cytochrome P450 family of enzymes with varying degree of hepatic glucuronidation. The mechanism of action is through various benzodiazepine receptors on the GABA receptor distributed in various regions of the central nervous system (CNS). The location of the GABA receptor in the CNS and the degree to which benzodiazepine drug binds to each receptor contributes to the overall differential effects of each medication. These medications are marketed and recommended generally as second line treatments or augmentation agents for various anxiety disorders such as generalized anxiety disorder, panic disorder, and social anxiety disorder. Benzodiazepines interact with or may potentiate the effects of other CNS-acting drugs such as alcohol, narcotics, barbiturates, nonbarbiturate hypnotics, antihistamines, phenothtazines, butyrophenones, monoamine oxidase inhibitors, tricyclic antidepressants, and anti-convulsants. There is high risk of dependency and withdrawal syndromes with long-term use.
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Jones, B.D.M., Husain, M.I. (2022). Tranquilizer/Anxiolytics: Benzodiazepines (Intermediate-Acting) – Alprazolam, Bromazepam, Clonazepam, Lorazepam. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_407
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