Management of benzodiazepine misuse and dependence
Management of benzodiazepine misuse and dependence
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DOI：
10.18773/austprescr.2015.055
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发表时间：
2015-10-01
影响因子：
2.7
通讯作者：
Murnion, Bridin
中科院分区：
文献类型：
--
作者：
Brett, Jonathan;Murnion, Bridin
长期使用苯二氮卓类药物有公认的危害。苯二氮卓类药物依赖包括依赖性、认知能力下降和福尔斯，预防和识别苯二氮卓类药物依赖非常重要。一个彻底的风险评估指导最佳管理和转诊的必要性。依赖的管理包括逐步苯二氮卓类药物戒断或维持治疗。处方干预，替代，心理治疗和药物治疗都可以发挥作用。除非患者是老年人，否则在戒断和维持治疗中改用长效苯二氮卓类药物是有帮助的。应在数周内逐渐减少剂量，以降低癫痫发作的风险。佐匹克隆和唑吡坦等药物的危害尚不清楚。依赖的管理方式与苯二氮卓类药物依赖相同。
There are well-recognised harms from long-term use of benzodiazepines. These include dependency, cognitive decline and falls.It is important to prevent and recognise benzodiazepine dependence. A thorough risk assessment guides optimal management and the necessity for referral.The management of dependence involves either gradual benzodiazepine withdrawal or maintenance treatment. Prescribing interventions, substitution, psychotherapies and pharmacotherapies can all contribute.Unless the patient is elderly, it is helpful to switch to a long-acting benzodiazepine in both withdrawal and maintenance therapy. The dose should be gradually reduced over weeks to lower the risk of seizures.Harms from drugs such as zopiclone and zolpidem are less well characterised. Dependence is managed in the same manner as benzodiazepine dependence.