Hostname: page-component-669899f699-2mbcq Total loading time: 0 Render date: 2025-05-06T10:07:13.007Z Has data issue: false hasContentIssue false
  • English
  • Français

The Damnation of Benzodiazepines

Published online by Cambridge University Press:  02 January 2018

F. Kräupl Taylor
F. Kräupl Taylor*
Affiliation:
The Bethlem Royal and Maudsley Hospitals, London
*
∗22 Redington Road, London NW3 7RG
Get access Rights & Permissions [Opens in a new window]

Abstract

It is argued that there are two kinds of benzodiazepine dependence: a therapeutic and a morbid kind. The therapeutic dependence is acceptable in that it mitigates the clinical manifestations in patients with long-standing and fluctuating anxious–depressive symptoms. The morbid dependence is an unfortunate complication which can arouse therapeutic concern because it ties patients to an excessive dosage, unless the penalty of a sometimes grim abstinence syndrome is paid on drug reduction. The present, often strident and threatening, damnation of benzodiazepines oversteps the mark and causes avoidable misery to patients whose well-being has become largely and therapeutically dependent on the drug.

Type
Point of View
Information
The British Journal of Psychiatry , Volume 154 , Issue 5 , May 1989 , pp. 697 - 704
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Ashton, H. (1984) Benzodiazepine withdrawal: an unfinished story. British Medical Journal, 288, 1135–1140.Google Scholar
Catalan, J., Gath, D., Edmonds, G., et al (1984) The effects of non-prescribing of anxiolytics in general practice. British Journal of Psychiatry, 144, 593–610.CrossRefGoogle ScholarPubMed
Charney, D. S., Heninger, G. R., Sternberg, D. E., et al (1982) Abrupt discontinuation of tricyclic antidepressant drugs: evidence for noradrenergic hyperactivity. American Journal of Psychiatry, 141, 377–386.Google Scholar
Engelhardt, H. T. Jr (1974) The disease of masturbation: values and the concept of disease. Bulletin of History of Medicine, 48, 235–248.Google Scholar
Feinstein, A. R. (1967) Clinical Judgment. Baltimore, Mdn: Williams & Wilkins.Google Scholar
File, S. E. (1988) The benzodiazepine receptor and its role in anxiety. British Journal of Psychiatry, 152, 599–600.Google Scholar
Fontaine, R., Chouinard, G. & Annable, L. (1984) Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment. American Journal of Psychiatry, 141, 848–852.Google Scholar
Garbus, S. B., Weber, M. A., Priest, R. T., et al (1979) The abrupt discontinuation of antihypertensive treatment. Journal of Clinical Pharmacology, 19, 476–486.Google Scholar
Gardos, G., Cole, J. O. & Tarsy, D. (1978) Withdrawal symptoms associated with antipsychotic drugs. American Journal of Psychiatry, 135, 1321–1324.Google Scholar
Golombok, S., Higgitt, A., Fonagy, P., et al (1987) A follow-up study of patients treated for benzodiazepine dependence. British Journal of Medical Psychology, 60, 141–149.Google Scholar
Hare, E. H. (1962) Masturbatory insanity: the history of an idea. Journal of Mental Science, 108, 1–25.Google Scholar
Kales, A., Scharf, M. B. & Kales, J. D. (1978) Rebound insomnia: a new clinical syndrome. Science, 201, 1039–1041.Google Scholar
Kales, A., Soldatos, C. R., Bixler, E. O., et al (1983) Rebound insomnia and rebound anxiety: a review. Pharmacology, 26, 121–137.Google Scholar
Kendell, R. E. (1975) The concept of disease and its implications for psychiatry. British Journal of Psychiatry, 127, 305–315.Google Scholar
Klein, H. E., Broucek, B. & Greil, W. (1981) Lithium withdrawal triggers psychotic states. British Journal of Psychiatry, 139, 255–256.Google Scholar
Kramer, J. C., Klein, D. F. & Fink, M. (1961) Withdrawal symptoms following discontinuation of imipramine therapy. American Journal of Psychiatry, 118, 549–550.Google Scholar
Lader, M. (1978) Benzodiazepines: the opium of the masses. Neuroscience, 3, 159–165.Google Scholar
Lader, M. & File, S. (1987) The biological basis of benzodiazepine dependence. Psychological Medicine, 17, 539–547.Google Scholar
Lader, M. & Lawson, C. (1987) Sleep studies and rebound insomnia: methodological problems, laboratory findings and clinical implications. Clinical Neuropharmacology, 10, 291–312.Google Scholar
Manheimer, D. I., Davidson, S. T., Balter, M. B., et al (1973) Popular attitudes and beliefs about tranquilizers. American Journal of Psychiatry, 130, 1246–1253.Google Scholar
Marks, J. (1985a) The Benzodiazepines. Use, Overuse, Misuse, Abuse. Lancaster: MTP Press.Google Scholar
Marks, J. (1985b) An international overview. In The Benzodiazepines. Current Standards for Medical Practice (eds Smith, D. E. & Wesson, D. R.), p. 76. Lancaster: MTP Press.Google Scholar
Merz, W. A. & Ballmer, U. (1983) Symptoms of barbiturate/benzodiazepine withdrawal syndrome in healthy volunteers: standardized assessment by a newly developed self-rating scale. Journal of Psychoactive Drugs, 15, 71–84.Google Scholar
Mirim, S. M., Schatzberg, A. F. & Creasy, D. E. (1981) Hypomania and mama after withdrawal of tricyclic antidepressants. American Journal of Psychiatry, 138, 87–89.Google Scholar
Morrison, A. B. (1974) Regulatory control of the Canadian Government over the manufacturing, distribution and prescribing of psychotropic drugs. In Social Aspects of the Medical Use of Psychotropic Drugs (ed. Cooperstock, R.). Toronto: Addiction Research Foundation.Google Scholar
Olsen, R. W. (1982) Drug interactions at the GABA-receptor-ionophore complex. Annual Review of Pharmacology and Toxicology, 22, 245–277.Google Scholar
Oswald, I. (1983) Benzodiazepines and sleep. In Benzodiazepines Divided. A Multidisciplinary Review (ed. Trimble, M. R.), pp. 1–16. Chichester: John Wiley.Google Scholar
Owen, R. T. & Tyrer, P. (1983) Benzodiazepine dependence. A review of the evidence. Drugs, 25, 385–398.Google Scholar
Petursson, H. & Lader, M. (1984) Dependence on Tranquillizers. Maudsley Monograph, no. 28. Oxford: Oxford University Press.Google Scholar
Rangno, R. E. & Langlois, S. (1982) Comparison of withdrawal phenomena after propranolol, metropolol and pindolol. British Journal of Clinical Pharmacology, 13, 345S–351S.Google Scholar
Rickels, K. (1981) Benzodiazepines: use and misuse. In Anxiety: New Research and Changing Concepts (eds Klein, D. F. & Rabkin, J. G.), pp. 1–26. New York: Raven Press.Google Scholar
Rickels, K., Case, G., Downing, R. W., et al (1983) Long-term diazepam therapy and clinical outcome. Journal of American Medical Association, 250, 767–771.Google Scholar
Rodrigo, E. K. & Williams, P. (1986) Frequency of self-reported ‘anxiolytic withdrawal’ symptoms in a group of female students experiencing anxiety. Psychological Medicine, 16, 467–472.Google Scholar
Scadding, J. G. (1967) Diagnosis: the clinician and the computer. Lancet, ii, 877–882.Google Scholar
Smith, D. E. (1983) In The Benzodiazepines: From Molecular Biology To Clinical Practice (ed. Costa, E.), pp. 406–410. New York: Raven Press.Google Scholar
Taylor, F. K. (1979) The Concepts of Illness, Disease And Morbus. Cambridge: Cambridge University Press.Google Scholar
Trewin, V. F., Pearce, V. & Veitch, G. B. A. (1986) Elderly patients at risk. British Journal of Pharmaceutical Practice, 8, 359–363.Google Scholar
Tyrer, P., Owen, R. & Dawling, S. (1983) Gradual withdrawal of diazepam after long-term therapy. Lancet, i, 1402–1406.Google Scholar
Tyrer, P. & Murphy, S. (1987) The place of benzodiazepines in psychiatric practice. British Journal of Psychiatry, 151, 719–723.Google Scholar
Virchow, R. (1860) Cellular Pathology, (trans. Chance, F.). London: John Churchill.Google Scholar
Williams, P. (1987) Long-term benzodiazepine use in general practice. In The Benzodiazepines in Current Clinical Practice (eds Freeman, H. & Rue, Y.). Royal Society of Medicine International Congress and Symposium Series, no. 114, pp. 19–33. London: RSM Services.Google Scholar
Williams, P., Murray, J. & Clare, A. (1982) A longitudinal study of psychotropic drug prescriptions. Psychological Medicine, 12, 201–206.Google Scholar
Winokur, A. & Rickels, K. (1981) Withdrawal and pseudo-withdrawal from diazepam therapy. Journal of Clinical Psychiatry, 42, 442–444.Google Scholar
World Health Organization (1964) Expert Committee on Addiction-Producing Drugs. Thirteenth Report. Technical Report Series, no. 273. Geneva: WHO.Google Scholar
World Health Organization (1974) Expert Committee on Drug Dependence. Twentieth Report. Technical Report Series, no. 551. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.