Benzodiazepines (BZDs)Dr Ahmad Eid, MBChB MScMed

Board-certified in psychiatry

Director of Abbassia Training Program (ATP)

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Place of BZDs in psychotropics

In clinical practice since 1961Commonly prescribed: 10 %

population / year

Cairo, Feb 2012

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Drug-grouping of BZDsSedative-hypnoticsAnxiolytics AntiepilepticsMuscle relaxants

Cairo, Feb 2012

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Available in Egypt: EDA Sep 20111. Alprazolam (Xanax): 0.25, 0.5, 1, 2 , 3

tab

2. Bromazepam (Calmepam): 1.5, 3 tab

3. Clordiazepoxide (incl. Librax): 10 tab

4. Clonazepam (Apetryl): 0.5, 2 tab 2.5 mg/ml oral drops

5. Diazepam (Neuril): 2, 5 tab, 2 mg/5ml syr, 5 mg/ml inj

6. Midazolam (Dormicum): 5 mg/ml inj, 7.5 tab

7. Oxazepam (Comedormir): 10, 15 tab

Cairo, Feb 2012

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GABAA receptor

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GABAA receptor

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Major Metabolic Relationships among Some of the Benzodiazepines

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Hepatic metabolism of BZDs

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BZDs Withdrawal syndrome

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Clinical indicationsAnxiety dsInsomnia: Not first line, 3 – 5 dsAugmenting antidepressants

/antipsychotics / mood stabilizers: in acute phase

Epilepsy, muscle spasm and pre anesthetic

Cairo, Feb 2012

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Clinical precautionsShort prescription: 2 – 4 wksAvoid in pts of COPD, elderly

Cairo, Feb 2012

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Related to BZDsAs sedative-hypnotics: Z drugs,

Melatonin agonist, and BarbsAs anxiolytics: buspirone

Cairo, Feb 2012