Benzodiazepines for anxiety disorders: maximising the benefits and minimising the risks

Starčević, Vladan

doi:10.1192/apt.bp.110.008631

Cited by 23 publications

(16 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Benzodiazepines are widely prescribed for their hypnotic, anxiolytic, muscle relaxant, and antiepileptic indications . Despite their common use, concerns remain over their long‐term safety.…”

Section: Introductionmentioning

confidence: 99%

Benzodiazepine usage and patient preference for alternative therapies: A descriptive study

Sake

Wong

Bartlett

et al. 2019

Health Science Reports

View full text Add to dashboard Cite

Background and aims The prevalence of chronic benzodiazepine use in primary care settings remains high despite clear evidence of adverse health outcomes resulting from long‐term use and the availability of effective alternative behavioural therapies. Eliciting factors influencing past or current usage experience of benzodiazepine users and their future behavioural intention regarding discontinuation or alternative behavioural therapy adoption could be useful in developing informed strategies facilitating successful benzodiazepine withdrawal in long‐term users. The aim of this study was to identify patient factors influencing their current long‐term benzodiazepine use, past withdrawal attempt, and future intention to trial safer alternative behavioural therapies. Additionally, the study also aimed to explore patients' preference for information sources on behavioural therapies. Methods Point of purchase surveys were conducted with patients obtaining benzodiazepines from selected pharmacies across New South Wales (NSW), Australia. Survey items included the Beliefs about Medicines Questionnaire (BMQ‐specific), questions about patient's sociodemographic characteristics, as well as their views about long‐term benzodiazepine use and behavioural therapies. Results Seventy‐five patients were recruited from 12 pharmacies across New South Wales (NSW). The surveys were conducted from November 2016 to July 2017. The mean (±SD) age of the participants was 54.3 (±16.7) with a range of 23 to 86 years, and 67% of the participants had been using the benzodiazepine for at least 1 year. Lower‐education levels, stronger beliefs about the necessity of use, and lower concerns about ongoing benzodiazepine use were significantly associated with prolonged use. Sixty‐four percent of the participants were not interested in behavioural therapies, and there was a significant relationship between the participants' future preference for behavioural therapies and their concerns about the potential adverse effects of benzodiazepines. A majority of the participants rated general practitioners (GPs) as their first choice and pharmacists as the second choice for discussing behavioural therapies. Conclusions Specific individual sociodemographic characteristics of benzodiazepine users and their medication‐related beliefs influence their current benzodiazepine usage and future intention to trial behavioural therapies as an alternative to their benzodiazepines. Based on the reported preferences of benzodiazepine users in this study, developing and evaluating GP‐pharmacist collaborative services to improve the uptake of behavioural therapies as an alternative to benzodiazepines can be recommended.

show abstract

Section: Introductionmentioning

confidence: 99%

Benzodiazepine usage and patient preference for alternative therapies: A descriptive study

Sake

Wong

Bartlett

et al. 2019

Health Science Reports

View full text Add to dashboard Cite

show abstract

“…Instead they bypass the brain's processing systems and act directly on mechanisms that control emotion (Nesse and Berridge 1997). Too often pharmacological treatments, such as anxiolytic drugs, have limited long term efficacy (Youngstedt and Kripke 2007), are symptom based, and are associated with severe side effects including adverse reactions, dependency (Buffett-Jerrott and Stewart 2002), addiction (Buffett-Jerrott and Stewart 2002;Lader 1994), relapse, and resistance to treatment (Starcevic 2012). A better understanding of the processes underlying human emotions may provide support for the administration of relaxation techniques such as meditation as a treatment for stress-related and anxiety disorders, as well as other psychiatric illnesses involving mood (Manzoni et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Self-Regulation of Breathing as a Primary Treatment for Anxiety

Jerath¹,

Crawford²,

Barnes

et al. 2015

Appl Psychophysiol Biofeedback

187

125

View full text Add to dashboard Cite

Understanding the autonomic nervous system and homeostatic changes associated with emotions remains a major challenge for neuroscientists and a fundamental prerequisite to treat anxiety, stress, and emotional disorders. Based on recent publications, the inter-relationship between respiration and emotions and the influence of respiration on autonomic changes, and subsequent widespread membrane potential changes resulting from changes in homeostasis are discussed. We hypothesize that reversing homeostatic alterations with meditation and breathing techniques rather than targeting neurotransmitters with medication may be a superior method to address the whole body changes that occur in stress, anxiety, and depression. Detrimental effects of stress, negative emotions, and sympathetic dominance of the autonomic nervous system have been shown to be counteracted by different forms of meditation, relaxation, and breathing techniques. We propose that these breathing techniques could be used as firstline and supplemental treatments for stress, anxiety, depression, and some emotional disorders.

show abstract

“…La capacità di indurre addizione da parte delle benzodiazepine è oggi molto controversa (Lader, 2011;Baldwin et al, 2013) ............................................................................................................................53 è generalmente temuta in base all'evidenza che molti individui con un'addizione abusano di benzodiazepine (Starcevic, 2014). In realtà, in assenza di disturbo da uso di altre sostanze, la dipendenza da benzodiazepine è di tipo terapeutico, una dipendenza fisica o, con un termine suggestivo, una dipendenza non additiva (Starcevic et al, 2012). Tale forma di dipendenza si connota per l'instaurarsi di tolleranza e per la comparsa di sindrome da sospensione (astinenza), all'interruzione dell'assunzione prolungata del farmaco; questi due fenomeni sono conseguenza di un normale adattamento fisiologico alla presenza di una sostanza che agisce sul SNC (Buhler et al, 2005;O'Brien et al, 2006( e si possono manifestare con un uso prolungato (sindrome da sospensione) o anche breve (tolleranza) (O'Brien et al, 2006;Baldwin et al, 2013) della stessa sostanza.…”

Section: Terapiaunclassified

Panico: nosografia di un'entità, clinica di un disturbo

Mancuso

Marucco²,

Vivo³

et al. 2017

Mission

View full text Add to dashboard Cite

Il termine "panico" affonda le sue radici nella mitologia della Grecia classica ed in particolare nella descrizione del terrore improvviso che colpiva gli uomini all'apparizione del dio Pan (Gigante e Presta, 1962). Il quadro sintomatologico del panico compare già nelle prime descrizioni dell'isteria ad opera di Ippocrate (460-377 a.C). Più recentemente, descrizioni di sintomi psichici e cardiorespiratori compatibili con l'attuale Disturbo di Panico (DP) possono essere rintracciate in vari testi di medicina dell'800: le "palpitazioni nervose" di Hope (1832), il "cuore irritabile di Da Costa (1871), la "neuropatia cerebro-cardiaca" di Krishaber (Kaplan et al., 1996) o la "nevrosi d'angoscia" di Freud (1894). La seconda metà del '900 si caratterizza per il progressivo affermarsi della farmacoterapia nei disturbi mentali. Klein (1964) verifica l'efficacia dell'imipramina (un antidepressivo triciclico) nel bloccare gli attacchi di panico, ma lo scarso effetto di tale molecola su altre manifestazioni ansiose. Con questa tecnica, denominata "dissezione farmacologica", Klein individua il nucleo fondamentale del DP a cui dà il nome di "ictus emotivo". Gli articoli di questa sezione sono sottoposti a referaggio doppiamente cieco (double blind peer review process) e seguono gli standard in uso per le pubblicazioni scientifiche a livello internazionale ed accettati dalle principali banche dati citazionali Copyright © FrancoAngeli Opera pubblicata con Licenza Creative Commons Attribuzione -Non commerciale -Non opere derivate. SAGGI, STUDI E RICERCHE Panico: nosografia di un'entità, clinica di un disturboPer i termini e le condizioni di utilizzo di questa opera consultare il sito: http://creativecommons.org/.

show abstract

Benzodiazepines for anxiety disorders: maximising the benefits and minimising the risks

Cited by 23 publications

References 36 publications

Benzodiazepine usage and patient preference for alternative therapies: A descriptive study

Benzodiazepine usage and patient preference for alternative therapies: A descriptive study

Self-Regulation of Breathing as a Primary Treatment for Anxiety

Panico: nosografia di un'entità, clinica di un disturbo

Contact Info

Product

Resources

About

Benzodiazepines for anxiety disorders: maximising the benefits and minimising the risks

Cited by 23 publications

References 36 publications

Benzodiazepine usage and patient preference for alternative therapies: A descriptive study

Benzodiazepine usage and patient preference for alternative therapies: A descriptive study

Self-Regulation of Breathing as a Primary Treatment for Anxiety

Panico: nosografia di un'entit&agrave;, clinica di un disturbo

Contact Info

Product

Resources

About

Panico: nosografia di un'entità, clinica di un disturbo