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Benzodiazepines

Benzodiazepines are a class of psychoactive drugs widely used for their sedative, anxiolytic, anticonvulsant, and muscle relaxant properties.
These compounds act on the gamma-aminobutyric acid (GABA) receptors in the brain, enhancing the inhibitory effects of GABA and producing a calming effect.
Benzodiazepines are commonly prescribed for the treatment of anxiety disorders, insomnia, seizures, and alcohol withdrawal.
However, they also carry a risk of dependence and abuse.
Ongoing research aims to explore new therapeutic applications, optimize dosing regimens, and develop safer alternatives for benzodiazepine use.1

Most cited protocols related to «Benzodiazepines»

Interviews were conducted by trained research staff in a private setting and data were recorded anonymously, unaccompanied by any unique identifiers. Subjects were first asked the single screening question, “How many times in the past year have you used an illegal drug or used a prescription medication for non-medical reasons?” (where a response of ≥1 is considered positive). If asked to clarify the meaning of “non-medical reasons”, the research associate added "for instance because of the experience or feeling it caused”. After subjects responded to the single screening question, they were asked if they had ever experienced any of a list of problems related to drug use. For this we modified the previously described Short Inventory of Problems-Alcohol and Drug (SIP-AD) questionnaire, which asks about problems ever experienced in the subject’s lifetime related to alcohol or drug use8 (link). We modified this by eliminating the word alcohol from the questions, a modification we hereafter refer to as the Short Inventory of Problems- Drug Use (SIP-DU). In a separate analysis (but in these subjects) we determined the reliability and validity of the SIP-DU as a measure of drug use consequences 9 . The computerized version of the Composite International Diagnostic Interview (CIDI) Substance Abuse Module was used for the assessment of current (12-month) drug use disorders 10 . This structured interview yields a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of drug abuse or dependence. In addition, as part of the CIDI, subjects were asked detailed questions about current (past year) use of illicit drugs (marijuana, cocaine, heroin, stimulants or hallucinogens) and non-medical use of prescription drugs. Following the interview subjects were asked to undergo oral fluid testing for the presence of common drugs of abuse (opiates, benzodiazepines, cocaine, methamphetamines, tetrahydrocannabinol (THC). Once collected, oral fluid was sent to an outside laboratory for analysis using methodology that yields results comparable to urine drug screening (Intercept™ immunoassay, OraSure Technologies, Bethlehem, PA)11 (link)–14 (link). In order to aid in the interpretation of drug test results subjects had been asked, as part of the interview, if they had recently been prescribed any drugs from a list of opiates or benzodiazepines. Because this question was added to the questionnaire during the study, responses were missing from 23 subjects who underwent oral fluid testing. Subjects were not told that they would be asked to undergo drug testing until the interview was complete. After completing the interview, they were compensated and thanked for their participation. They were then asked to undergo oral fluid testing and a second informed consent process was completed. Following the single drug screening question, but before the other assessments, the 10-item Drug Abuse Screening Test (DAST-10) was administered for comparison 4 (link). As part of a parallel study on screening for unhealthy alcohol use, subjects were also asked a single alcohol screening question (preceding the drug screening question), two other brief alcohol screening questionnaires and a calendar based assessment of past-month alcohol consumption (all after the drug screen and prior to the CIDI) 7 (link).
Publication 2010
Alcohol Problem Benzodiazepines Cannabis sativa Central Nervous System Stimulants Cocaine Diagnosis Dronabinol Drug Use Disorders Ethanol Hallucinogens Heroin Illicit Drugs Immunoassay Methamphetamine Opiate Alkaloids Pharmaceutical Preparations Substance Abuse Substance Abuse Detection Urine
This was a single-center, double-blind, randomized, crossover, placebo-controlled study conducted to assess the efficacy and safety of a single intravenous infusion of the NMDA antagonist ketamine combined with lithium or valproate therapy in the treatment of bipolar I or II depression. As noted previously, subjects were first required to have failed to respond to a prospective open trial of therapeutic levels of either lithium or valproate at the NIMH for a minimum of 4 weeks, regardless of whether they were already taking therapeutic levels of lithium or valproate at admission. During the entirety of the study, patients were required to take either lithium or valproate within the specified range and were not allowed to receive any other psychotropic medications (including benzodiazepines) or to receive structured psychotherapy. Lithium and valproate levels were obtained weekly. Vital signs and oximetry were monitored during the infusion and for 1 hour after. Electrocardiograms, complete blood counts, electrolyte panels, and liver function tests were obtained at baseline and at the end of the study.
Following nonresponse to open treatment with lithium or valproate and a 2-week drug-free period (except for treatment with lithium or valproate), subjects received intravenous infusions of saline solution and 0.5-mg/kg ketamine hydrochloride 2 weeks apart using a randomized, double-blind, crossover design. The ketamine dose was based on previous controlled studies of patients with major depressive disorder.30 (link),33 (link),34 (link)
Patients were randomly assigned to the order in which they received the 2 infusions via a random-numbers chart. Study solutions were supplied in identical 50-mL syringes containing either 0.9% of saline or ketamine with the additional volume of saline to total 50 mL. Ketamine forms a clear solution when dissolved in 0.9% saline. The infusions were administered over 40 minutes via a Baxter infusion pump (Deerfield, Illinois) by an anesthesiologist in the perianesthesia care unit. All staff, including the anesthesiologist, was blind to whether drug or placebo was being administered.
Publication 2010
Anesthesiologist Benzodiazepines Complete Blood Count Electrocardiogram Electrolytes Infusion Pump Intravenous Infusion Ketamine Ketamine Hydrochloride Lithium Liver Function Tests Major Depressive Disorder N-Methylaspartate Normal Saline Oximetry Patients Pharmaceutical Preparations Placebos Psychotherapy Psychotropic Drugs Safety Saline Solution Signs, Vital Syringes Valproate Visually Impaired Persons

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Publication 2012
Anesthesia Anesthesiologist Benzodiazepines Depression, Bipolar Electrolytes Infusion Pump Intravenous Infusion Ketamine Ketamine Hydrochloride Lithium Liver Function Tests N-Methylaspartate Normal Saline Oximetry Patients Pharmaceutical Preparations Placebos Psychotherapy Psychotropic Drugs Safety Saline Solution Signs, Vital Syringes Valproate Visually Impaired Persons
CALM used a web-based monitoring system,16 modeled on the IMPACT intervention,2 (link) with newly developed anxiety content, and a computer-assisted CBT program.17 (link) ACSs received six half days of didactics, which focused on mastering the CBT program, plus motivational interviewing (modified for anxiety concerns) to enhance engagement, outreach strategies for ethno-racial and impoverished minorities, and a medication algorithm for anxiety.21 (link) CBT training also included role-playing, and required successful completion of two training patients over several months.
CALM patients initially received their preferred treatment, either medication, CBT, or both, over 10 to 12 weeks. Since the effects of CBT delivered for one disorder are known to generalize to co-morbid disorders,22 patients with multiple anxiety disorders were asked to choose the most disabling or distressing disorder to focus on with the expectation that their co-morbid disorders would also improve. The CBT program, a “repackaging” based on already validated CBT treatments,23 included 5 generic modules (education, self-monitoring, hierarchy development, breathing training, relapse prevention) and 3 modules (cognitive restructuring, exposure to internal and external stimuli) tailored to the four specific anxiety disorders. CBT was administered by the ACS (typically in 6 to 8 weekly sessions), while medication was prescribed. A local study psychiatrist provided single session medication management training to providers using a simple algorithm, as needed consultation by phone or e-mail, and very rarely, a face to face assessment for complex or treatment refractory patients. The algorithm emphasized first line use of SSRI or SNRI antidepressants, dose optimization, side effect monitoring, followed by second and third step combinations of two antidepressants or an antidepressant and benzodiazepine for refractory patients.21 (link) For medication management, the ACS provided adherence monitoring, counseling to avoid alcohol and optimize sleep hygiene and behavioral activity, and relayed medication suggestions from the supervising psychiatrist to the PCP.
The ACS tracked patient outcomes on a web-based system by entering scores for the OASIS and a 3-item version of the Patient Health Questionnaire-9 (PHQ-9), and examining graphical progress over time. The goal was either clinical remission, defined as an OASIS < 5 = “mild”, sufficient improvement such that the patient did not want further treatment, or improvement with residual symptoms or other emergent problems requiring a non-protocol psychotherapy (ie, DBT, family or dynamic psychotherapy). Symptomatic patients thought to benefit from additional treatment with CBT or medication could receive more of the same modality (“stepping up”) or the alternative modality (“stepping over”), for up to three more steps of treatment. After treatment completion, patients were entered into “continued care” and received monthly follow-up phone calls to reinforce CBT skills and/or medication adherence. ACSs interacted regularly with PCPs in person and over the phone. PCPs remained the clinician of record and prescribed all medications. All ACSs received weekly supervision from a psychiatrist and psychologist.
UC patients continued to be treated by their physician in the usual manner with no intervention, ie, with medication, counseling (7 of 17 clinics had limited in-clinic mental health resources, usually a single provider with limited familiarity with evidence based psychotherapy24 (link)) or referral to a mental health specialist. After the eligibility diagnostic interview, the only contact UC patients had with study personnel was for assessment by phone.
Publication 2010
ACSS2 protein, human Antidepressive Agents Anxiety Disorders Benzodiazepines CREB3L1 protein, human Diagnosis Eligibility Determination Ethanol Face Generic Drugs Mental Health Minority Groups Patients Pharmaceutical Preparations Physicians Pneumocystosis Psychiatrist Psychologist Psychotherapy Relapse Prevention SNRIs Supervision
All analyses were performed using SAS version 9.2 (SAS Institute, Cary, NC), and we used a two tailed P value of less than 0.05 to define statistical significance. We initially used descriptive statistics to characterise the cohort for patterns of post-discharge opioid use. To compare the characteristics of patients who did or did not exhibit prolonged opioid use after discharge we also used bivariate tests (two sample t test, Mann-Whitney U test, χ2 test, Fisher exact test).
We used multivariable logistic regression modelling to determine the adjusted association of prolonged opioid use after discharge (≥1 prescriptions within 1-90 days after surgery along with ≥1 prescriptions within 91-180 days after surgery) with age (categorised as 66-75, 76-85, and ≥86 years), sex, surgery, fifth of neighbourhood income, rural residence, comorbidities (coronary artery disease, heart failure, cerebrovascular disease, peripheral vascular disease, diabetes, hypertension, pulmonary disease, chronic renal insufficiency, malignancy), and preoperative drug use (β blockers, ACE inhibitors, angiotensin receptor blockers, statins, benzodiazepines, SSRIs). All predictor variables were included simultaneously in the multivariable regression model. In the primary analysis, we included all participants in the cohort regardless of whether they survived up to 180 days after surgery. In a sensitivity analysis, we repeated the analyses after restricting the cohort to only those who survived at least 180 days after surgery.
Publication 2014
Angiotensin-Converting Enzyme Inhibitors Angiotensin Receptor Antagonists Benzodiazepines Cerebrovascular Disorders Chronic Kidney Insufficiency Congestive Heart Failure Coronary Artery Disease Diabetes Mellitus High Blood Pressures Hydroxymethylglutaryl-CoA Reductase Inhibitors Hypersensitivity Lung Diseases Malignant Neoplasms Operative Surgical Procedures Opioids Patient Discharge Patients Peripheral Vascular Diseases Pharmaceutical Preparations Prescriptions Selective Serotonin Reuptake Inhibitors

Most recents protocols related to «Benzodiazepines»

Example 6

The following example provides details of a study used to determine whether alprazolam-induced changes in subjective experience during psilocybin therapy are due to changes in 5-HT2A occupancy. If not, downstream molecular and cellular effects that may be important in psilocybin's therapeutic effects may be preserved after co-treatment with a benzodiazepine.

In this study, [11C]CIMBI-36 (a selective 5-HT2A receptor agonist positron emission tomography (PET) radioligand) will be used to investigate whether 5-HT2A binding is affected by placebo vs. alprazolam.

At time t=0, subjects will be administered 25 mg psilocybin (PSI) in combination with either a placebo, or alprazolam. At t=2 hours, subjects will be given a tracer dose of [11C]CIMBI-36. At t=2-3 hours, a PET scan will be performed, to determine whether 5-HT2A binding is affected by either dose of alprazolam.

This study may optionally be performed using diazepam instead of alprazolam.

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Patent 2024
Alprazolam Benzodiazepines Cells Cimbi-36 Diazepam Placebos Positron-Emission Tomography Psilocybin Therapeutic Effect
Participants ranged in age from 25 to 58 (mean age 41). Their current living situation was reported as either currently homeless (38%), supported housing (50%), private rented accommodation (6%) and 6% were vulnerably housed in unsuitable accommodation.
Primary presenting substance misuse was reported as opiates (74%), alcohol (13%), and benzodiazepines (13%). Self-identified poor mental health was characterised as suffering from long term depression and anxiety, and 100% had trouble sleeping. 63% of participants reported suicidal ideation within the past 12 months. 25% reported that they had ever been admitted to a psychiatric facility. A minority had psychiatric diagnoses (6%) which were reported as schizophrenia and personality disorder.
Within the previous 12 months, 56% had accessed housing support services, 56% had used substance misuse services, 38% had accessed support for domestic abuse and 25% had accessed mental health support. Fifty percent had visited their GP at least once. Significant acute healthcare use was reported, with at least 18 individual admissions to A&E reported within the group in the previous 12 months.
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Publication 2023
Anxiety Benzodiazepines Diagnosis, Psychiatric Drug Abuse Ethanol Mental Health Minority Groups Ocular Accommodation Opiate Alkaloids Personality Disorders Persons, Homeless Schizophrenia
Data for this study were drawn from two open prospective cohort studies of PWUD in Vancouver, Canada: the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS). Both cohorts have been described in detail in previous literature [24 (link), 27 (link)]. However, to briefly summarize, these cohorts have been recruiting participants through community-based methods, including street outreach, self-referral, and word of mouth since May of 1996. VIDUS includes adults (18 years and older) who are HIV-negative and have injected unregulated drugs within the month prior to their enrolment. ACCESS participants are HIV-positive adults who used any unregulated substance (other than or in addition to cannabis) within the month prior to their enrolment. Participants in the VIDUS cohort who HIV seroconvert after their enrolment are transferred to the ACCESS cohort. All participants provided written informed consent at enrolment and ethics has been approved by Providence Health Care/University of British Columbia’s Research Ethics Board. Both cohorts use harmonized study protocols to facilitate pooled analyses.
At baseline and at 6-month intervals afterwards, participants complete interviewer- and nurse-led questionnaires and provide blood samples for serology, as well as urine for drug screening. The questionnaire covers a variety of topics including demographics, substance use, healthcare access, and socio-structural exposures. To compensate participants for their involvement, participants receive a $40 CAD stipend for every study visit.
Due to the COVID-19 pandemic, all in-person data collection was suspended between March 2020 and July 2020. After July 2020, infection control measures were put in place to resume data collection. Participant interviews were completed over telephone or videoconferencing. Study-owned cell phones and private spaces were loaned to those who required them. They were then able to pick up their cash honoraria in person or have it e-transferred if they had access to a bank account.
Between March and July of 2020, study questionnaires were modified to include questions regarding the COVID-19 pandemic. One of these questions was used to assess the primary outcome of this study, which read as follows: “Has the frequency of your use of these sites [i.e., SCS/OPS] changed since the beginning of the public health emergency?”. The outcome was dichotomized using the following responses: “I use them less” vs. “I use them more” or “My use stayed the same”. Potential correlates were identified based on past studies that assessed SCS access among PWUD [8 (link), 25 (link)], and included: age (per year older), self-identified gender (man vs. woman/other), ethnicity/ancestry (white vs. Black, Indigenous, and people of colour), education (high school or greater vs. other), employment (yes vs. no), residence in Downtown Eastside neighbourhood in Vancouver (yes vs. no), daily non-medical prescription opioid use (yes vs. no), daily cocaine use (yes vs. no), daily crystal methamphetamine use (yes vs. no), daily non-injection crack-cocaine use (yes vs. no), benzodiazepine use (yes vs. no), suspected that a drug used contained fentanyl (yes vs. no), used drugs alone (yes vs. no), engagement in opioid agonist therapy (yes vs. no), non-fatal overdose (yes vs. no), witnessed an overdose (yes vs. no), experience physical violence (yes vs. no), syringe/ drug use equipment sharing (yes vs. no), inability to access treatment (yes vs. no), unstable housing (yes vs. no), sex work (yes vs. no), incarceration (yes vs. no), jacked up (this refers to being stopped, searched, or detained) by the police (yes vs. no), cohort/ HIV status (ACCESS vs. VIDUS), ever tested positive for COVID-19 (yes vs. no), concern about COVID-19 on a scale from 1 to 10, with 10 indicating greatest concern (1–5 vs. 6–10), any chronic health conditions (yes vs. no), and ease of accessing SCS/OPS changed since COVID-19 (same vs. easier vs. harder). All drug use and behavioral variables refer to the 6 months prior to questionnaire date unless otherwise indicated.
Univariable and multivariable logistic regression analyses were used to assess the associations between the correlates of interest and reduced frequency of SCS/OPS use since COVID-19. Correlates of interest with a univariable p-value < 0.10 were included in a backward elimination procedure, with the least significant variable removed at each step until the lowest Akaike Information Criterion (AIC) was achieved. All p-values were two-sided and all statistical analyses were conducted using SAS version 9.4 (SAS Institute, Cary, North Carolina, United States).
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Publication 2023
Abuse, Physical Acquired Immunodeficiency Syndrome Adult Benzodiazepines BLOOD Cannabis Chronic Condition Cocaine COVID 19 Crack Cocaine Drug Abuser Drug Overdose Emergencies Ethnicity Fentanyl Gender Infection Control Interviewers Methamphetamine Nurses Opioids Oral Cavity Pharmaceutical Preparations Substance Use Urine Woman
We identified the following potential confounders a priori using directed acyclic graphs28 (link): age at pregnancy, primiparous, marital status, smoking during pregnancy, and Charlson Comorbidity Index (calculated based on 19 conditions; definition in the eMethods in Supplement 1). We used a history of self-harm (definition in the eMethods in Supplement 1) and psychiatric diagnoses at any time before pregnancy, including schizophrenia, bipolar disorder, depression, other mood disorders, and others (International Classification of Diseases, Eighth Revision [ICD-8] and Tenth Revision [ICD-10] codes listed in eTable 2 in Supplement 1); number of psychiatric emergencies; and coprescribed medications (opioid analgesics, antiseizure medications, antipsychotics, benzodiazepine/z-hypnotics, or anxiolytics; ATC codes listed in eTable 3 in Supplement 1) in the 6 months before pregnancy as a proxy for disease severity. In addition, we included filling prescriptions for 2 or more classes of antidepressants and having an average daily dose of an antidepressant greater than 1 fluoxetine dose equivalent (ie, 40 mg fluoxetine)29 (link) in the 6 months before pregnancy as an additional proxy of the severity of mental illnesses.
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Publication 2023
Analgesics, Opioid Anti-Anxiety Agents Antidepressive Agents Antipsychotic Agents Benzodiazepines Bipolar Disorder Diagnosis, Psychiatric Dietary Supplements Emergencies Fluoxetine Hypnotics Mood Disorders Pharmaceutical Preparations Pregnancy Prescriptions Schizophrenia
The study was approved by the Brandeis University institutional review board and was deemed exempt for the need for informed consent by the Washington State Department of Social and Health Services institutional review board because the data were deidentified, in accordance with 45 CFR §46. The report follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for case-control studies. We examined Medicaid outpatient, inpatient, residential, and pharmacy claims from Washington State for 2016 to 2019. Using a clinically driven approach, we captured people who may not have been administratively deemed to have a disability for access to income supports and Medicaid, but who had reached a clinical threshold for diagnosis. Washington is a Medicaid expansion state, with a full continuum of SUD care, including all types of MOUD. For each year, we included adults aged 18 to 64 years with an OUD diagnosis who were continuously eligible for full Medicaid benefits for 12 months, to observe full service use. We defined OUD as at least 1 claim for outpatient, inpatient, or residential services with an OUD diagnosis code in a calendar year (eTable 1 in Supplement 1). We excluded 2587 people eligible for both Medicare and Medicaid because Medicare services were unobservable, 1132 people with a benzodiazepine prescription during the same year because concurrent MOUD is associated with increased risk of adverse effects,23 (link) and 132 people because prescription days supply was missing (eFigure in Supplement 1). Analyses of MOUD treatment continuity required continuous 6 months of data following the first evidence of MOUD, requiring a look back for claims occurring in the first week of the year to see whether they were the end of an earlier episode.
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Publication 2023
Adult Benzodiazepines Continuity of Patient Care Diagnosis Dietary Supplements Disabled Persons Ethics Committees, Research Inpatient Outpatients

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Diazepam is a benzodiazepine-class pharmaceutical compound used in various laboratory and research applications. It functions as a central nervous system depressant with sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties.
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More about "Benzodiazepines"

Benzodiazepines are a class of psychoactive drugs that are widely used for their sedative, anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties.
These compounds, which include drugs like Diazepam (Valium), act on the gamma-aminobutyric acid (GABA) receptors in the brain, enhancing the inhibitory effects of GABA and producing a calming effect.
Benzodiazepines are commonly prescribed for the treatment of anxiety disorders, insomnia, seizures, and alcohol withdrawal.
However, they also carry a risk of dependence and abuse, which has led to ongoing research to explore new therapeutic applications, optimize dosing regimens, and develop safer alternatives.
The SAS 9.4 software and Stata version 15 are statistical analysis tools that can be used to study the effects and usage of benzodiazepines.
The HiPrep™ 26/10 Desalting Column from GE is a laboratory tool that can be used in benzodiazepine research, while the DrugTest 5000 is a device used for the detection of benzodiazepines and other drugs.
Compounds like Picrotoxin and FG-7142 are also related to benzodiazepines, as they interact with the GABA receptors in the brain and can have similar effects.
Ongoing research aims to explore the full potential of benzodiazepines and develop safer alternatives to address the issues of dependence and abuse.