Bensodiazepin

Benzodiazepines, sometimes written bensodiazepin in some languages, are a class of psychoactive drugs used medically for their sedative, anxiolytic, anticonvulsant and muscle-relaxant properties. They act as positive allosteric modulators of the gamma-aminobutyric acid type A (GABA-A) receptor, enhancing the effect of the inhibitory neurotransmitter GABA and increasing neuronal inhibition throughout the central nervous system.

Commonly prescribed benzodiazepines include diazepam, lorazepam, temazepam, alprazolam and clonazepam. They vary in onset and duration of action, with short-acting agents used for insomnia and longer-acting agents used for anxiety or seizure disorders. They are typically prescribed for short-term relief due to risks of tolerance and dependence.

Uses of benzodiazepines include treatment of anxiety disorders, panic disorder, insomnia (short-term), seizure disorders (clonazepam, diazepam), muscle spasm, agitation in certain medical conditions, and as part of alcohol withdrawal management. They may be used as premedication for certain medical procedures and for acute agitation when appropriate.

Pharmacokinetics and safety considerations: Benzodiazepines are metabolized in the liver, with many agents processed by cytochrome P450 enzymes such as CYP3A4 and CYP2C19, though some (such as lorazepam) undergo conjugation with limited hepatic metabolism. Half-lives range from a few hours to several days. Elderly patients and those with liver impairment are at higher risk of accumulation and daytime sedation. Long-term use can lead to tolerance, dependence and withdrawal syndromes that may be severe, including seizures.

Risks and cautions: They can cause sedation, cognitive impairment, and motor incoordination; combining with alcohol or other central nervous system depressants increases the risk of respiratory depression and overdose. Contraindications include myasthenia gravis, sleep apnea, severe respiratory insufficiency or coma; caution in pregnancy and with a history of substance use disorder. Use should be under medical supervision and, when appropriate, for the shortest feasible duration.