Many physicians are reluctant to prescribe benzodiazepines for fear that patients will become addicted. This book is designed to help practicing physicians make rational, carefully considered assessments of the risks and benefits of using benzodiazepines in the treatment of their patients. The book sheds light on this controversial area by presenting results of scientific studies and well-controlled treatment trials. This volume is divided into four sections. In the first section, recent findings of basic scientists regarding the action of benzodiazepines in the brain are presented to provide essential background for understanding their clinical effects. A chapter about pharmacokinetics and pharmacodynamics gives a rational basis for the choice of a particular benzodiazepine in a given clinical situation. In the second section four chapters discuss indications for and the efficacy of benzodiazepines in specific disorders within the general areas of anxiety and depression, adjustment and stress syndromes, psychosis, and sleep disorders. The third section discusses risks of benzodiazepines, including psychomotor and cognitive effects, dependence and withdrawal and abuse liability. Information regarding those patients or treatment regimens with the greatest risk of these adverse effects is presented. To conclude, the fourth section considers special populations and issues, including treatment of the elderly and medically ill and the use of benzodiazepines in combination with psychotherapy.
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