They lack the sedation and the dependence associated with benzodiazepines and cause much less cognitive impairment.

They may be less effective than benzodiazepines in patients who have been previously treated with benzodiazepines as they do not provide the sedation that these patients may expect or equate with anxiety relief.

Today, " minor tranquilizer " can refer to anxiolytic and / or hypnotic drugs such as the benzodiazepines and nonbenzodiazepines which have some antipsychotic properties and are recommended for concurrent use with antipsychotics, and are useful for insomnia or drug-induced psychosis.

People with alcoholism also sometimes have other addictions, including addictions to benzodiazepines, which may complicate this step.

As with similar substances with a sedative-hypnotic mechanism, such as barbiturates and benzodiazepines, withdrawal from alcohol dependence can be fatal if it is not properly managed.

Due to adverse effects associated with the long-term use of benzodiazepines, withdrawal from benzodiazepines, in general, leads to improved physical and mental health.

Moreover, in geriatric medicine, if benzodiazepines are necessary, those with short half-lives ( e. g. lorazepam & oxazepam ) are preferred, as they do not require hepatic oxidation.

Due to their effectiveness, tolerability, and rapid onset of anxiolytic action, benzodiazepines are frequently used for the treatment of anxiety associated with panic disorder.

Selective serotonin reuptake inhibitors are likely to be the best choice of pharmacotherapy for many patients with panic disorder, but benzodiazepines are also often used, and some studies suggest that these medications are still used with greater frequency than the SSRIs.

APA does not recommend benzodiazepines for persons with depressive symptoms or a recent history of substance abuse.

And, based on the findings of placebo-controlled studies, they do not recommend use of benzodiazepines beyond two to four weeks, as tolerance and physical dependence develop rapidly, with withdrawal symptoms including rebound anxiety occurring after six weeks or more of use.

Nevertheless, benzodiazepines continue to be prescribed for the long-term treatment of anxiety disorders, although specific antidepressants and psychological therapies are recommended as the first-line treatment options with the anticonvulsant drug pregabalin indicated as a second-or third-line treatment and suitable for long-term use.

NICE stated that long-term use of benzodiazepines for panic disorder with or without agoraphobia is an unlicensed indication, does not have long-term efficacy, and is, therefore, not recommended by clinical guidelines.

Likewise, Canadian Psychiatric Association ( CPA ) recommends benzodiazepines alprazolam, bromazepam, lorazepam, and diazepam only as a second-line choice, if the treatment with two different antidepressants was unsuccessful.

However, in some cases, a prolonged treatment with benzodiazepines as the add-on to an antidepressant may be justified.

NICE review pointed out that short-acting Z-drugs were inappropriately compared in clinical trials with long-acting benzodiazepines.

There have been no trials comparing short-acting Z-drugs with appropriate doses of short-acting benzodiazepines.

Prolonged convulsive epileptic seizures are a medical emergency that can usually be dealt with effectively by administering fast-acting benzodiazepines, which are potent anticonvulsants.

If used in pregnancy, those benzodiazepines with a better and longer safety record, such as diazepam or chlordiazepoxide, are recommended over potentially more harmful benzodiazepines, such as alprazolam or triazolam.

While proven useful in the past, barbiturates are no longer commonly used in psychiatry ; thus the option of either benzodiazepines or ECT.

Some benzodiazepines have demonstrated effectiveness in sleep maintenance in the short term but in the longer term are associated with tolerance and dependence.

Lorazepam has relatively potent anxiolytic effects and its best-known indication is the short-term management of severe anxiety ; the FDA advises against use of benzodiazepines such as lorazepam for longer than two to four weeks.

With long-term use of benzodiazepines, it is unclear whether cognitive impairments fully return to normal after cessation of therapy ; cognitive deficits persist for at least six months after withdrawal, but longer than six months may be required for recovery of cognitive function.

Recovery from benzodiazepines tends to take a lot longer than recovery from alcohol, but people can regain their previous good health.

Many benzodiazepines ( including midazolam ) have longer half-lives than flumazenil.

Withdrawal is best managed by transferring the physically dependent patient to an equivalent dose of diazepam because it has the longest half-life of all of the benzodiazepines, is metabolised into long-acting active metabolites and is available in low-potency tablets, which can be quartered for smaller doses.

Intermediate half-life benzodiazepines are also useful for patients with difficulty in maintaining sleep ( e. g. loprazolam, lormetazepam, temazepam ).

The mind and judgment altering effects of Zaleplon are similar to those of many other benzodiazepines but the fast-acting nature and short half-life of the chemical mean that high dosages set on much more quickly and last for short periods of time ( usually from 45 to 60 minutes ).

These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures.

However, adverse effects such as behavioural disinhibition may make benzodiazepines inappropriate for some acutely psychotic patients.

Because of the medical problems that can be caused by withdrawal, alcohol detoxification is carefully controlled and may involve medications such as benzodiazepines such as diazepam ( Valium ).

On the other hand, short-acting benzodiazepines may lead to breakthrough seizures, and are, therefore, not recommended for detoxification in an outpatient setting.

The benzodiazepines chlordiazepoxide ( Librium ) and oxazepam ( Serax ) have largely replaced phenobarbital for detoxification.

Alcohol is also cross tolerant with benzodiazepines and more toxic and thus caution is needed to avoid replacing one dependence with another.

The elderly are more sensitive to the side effects of benzodiazepines, and poisoning may even occur from their long-term use.

Benzodiazepine addiction, is a far more dangerous dependency to have because unlike dependence to opiates and other drug classes, benzodiazepines and their counter-parts the z-drugs ( ambien for example ) are lethal in withdrawal.

Treatment may include one or more of the following: physical therapy ; occupational therapy ; speech therapy ; drugs to control seizures, alleviate pain, or relax muscle spasms ( e. g. benzodiazepines, baclofen and intrathecal phenol / baclofen ); hyperbaric oxygen ; the use of Botox to relax contracting muscles ; surgery to correct anatomical abnormalities or release tight muscles ; braces and other orthotic devices ; rolling walkers ; and communication aids such as computers with attached voice synthesizers.

In comparing the options, a systematic review found that benzodiazepines and nonbenzodiazepines have similar efficacy that is not significantly more than for antidepressants.

Zolpidem is more selective and zaleplon is highly selective for the α < sub > 1 </ sub > subunit, thus giving them an advantage over benzodiazepines in terms of sleep architecture and a reduction in side-effects.

Children and the elderly are more sensitive to the adverse effects of benzodiazepines.

Lorazepam appears to have more profound adverse effects on memory than other benzodiazepines ; it impairs both explicit and implicit memory.

These effects are seen as more common with lorazepam than other benzodiazepines.

The elderly metabolise benzodiazepines more slowly than younger people and are more sensitive to the adverse effects of benzodiazepines compared to younger individuals even at similar plasma levels.

Additionally, the elderly tend to take more drugs which may interact or enhance the effects of benzodiazepines.

Short-acting benzodiazepines such as lorazepam are more likely to cause a more severe withdrawal syndrome compared to longer-acting benzodiazepines.

Patients are ideally nursed in a kind, nonfrustrating environment, since, when given or taken in high doses, benzodiazepines are more likely to cause paradoxical reactions.

In children, clonidine premedication is at least as effective as benzodiazepines, in addition to having a more favourable side effect profile.

The therapeutic and side effect profile of nepenthe as reported may also very well be the result of some form of belladonna-type anticholinergic being present, that drug being well known for its amnesia and other properties, the former of which is considerably more potent than opium in this respect, and belladonna or separated alkaloids, especially scopolamine, were widely used in surgery and medical and dental procedures for many years before medium and short acting benzodiazepines such as alprazolam, diazepam, chlordiazepoxide, midazolam and others.