benzodiazepiner

Benzodiazepines are a class of psychoactive drugs that act as positive allosteric modulators of the gamma-aminobutyric acid type A (GABA-A) receptor. By enhancing the activity of the primary inhibitory neurotransmitter GABA, they produce anxiolytic, sedative, hypnotic, muscle-relaxant, and anticonvulsant effects. They are used for short-term management of anxiety and insomnia, as well as in the treatment of seizures, muscle spasticity, and alcohol withdrawal, and are sometimes employed as premedication for medical procedures.

Pharmacology and administration vary among agents. Some benzodiazepines are long-acting with active metabolites (for example diazepam), while others are short- or intermediate-acting (such as triazolam, temazepam, or lorazepam). Onset of action and duration influence dosing, dependence risk, and withdrawal profile. Tolerance and physical dependence can develop with regular use, and abrupt discontinuation may cause rebound anxiety, insomnia, agitation, tremor, or seizures.

Risks and monitoring: Benzodiazepines can cause cognitive and psychomotor impairment, daytime sedation, and increased risk of falls in older adults. They can interact dangerously with alcohol, opioids, and other central nervous system depressants. In pregnancy and early infancy there are potential teratogenic and neonatal withdrawal risks. In many countries they are controlled substances; in the United States they are classified as Schedule IV drugs.

Guidelines typically recommend using the lowest effective dose for the shortest feasible duration, often 2 to 4 weeks for anxiety or insomnia. When longer use is necessary, gradual tapering is advised to minimize withdrawal. Non-pharmacologic therapies and alternative medications are encouraged to reduce long-term dependence.