Enhanced Relief of Phobias by Flooding During Waning Diazepam Effect

Abstract

Sedatives such as barbiturates, benzodiazepines and alcohol are valuable reducers of anxiety, but their effects do not endure for long after the drug has been metabolized and excreted. Phobics often become able to enter their phobic situation under the influence of sedatives, but as the drug effect wears off they begin to escape from the situation once more. This might be a form of drug-dissociative behaviour. In animal experiments, behaviour learned in the sedative drugged state often fails to transfer to the undrugged state (Miller, 1964). However, this effect might be more pronounced during the phase of peak drug effect than during the phase when the drug effect is wearing off. In rats, exposure to the phobic situation during slow withdrawal of sedative drugs was found to be effective in extinguishing conditioned avoidance responses (Sherman, 1967). That more lasting behavioural changes can follow treatment given both in the drug and in the non-drug state is suggested by evidence adduced by Baum (1971); he found that, in rats, avoidance behaviour which was learned both in the alcohol and in the non-drug state was more resistant to extinction than avoidance acquired in a non-drug state alone. The same might apply to approach behaviour in human phobics.

Benzodiazepines and exposure-based cognitive behavior therapies for panic disorder: conclusions from combined treatment trials

“…That is not to say that there are no advantages of such a combination. Studies have fairly consistently found that benzodiazepines can reduce anxiety and discomfort during exposure therapy, and at least one study of patients with specific phobias (75) found that patients who were given a benzodiazepine moved more quickly up their exposure hierarchies. It is possible that those effects might reduce attrition from cognitive behavior therapy or shorten the time required for treatment.…”

Uçuş fobisinin (aviofobi) göz hareketleri ile duyarsızlaştırma ve yeniden işleme (EMDR) yöntemi ile tedavisi: Bir olgu sunumu

“…In terms of pharmacotherapy; there are some studies performed with diazepam, imipramine and beta-blockers and enough efficiency has not been specified yet (12,13). It is difficult to say that pharmacotherapy is efficient in the treatment of specific phobias.…”

Maintenance time of sedative effects after an intravenous infusion of diazepam: A guide for endoscopy using diazepam

“…The mean plasma elimination halflife of diazepam in PMs of CYP2C19 has been reported to be much longer than that in homozygous EMs: those values after a single oral dose of diazepam were 84.0 ± 13.7 h for PMs, 62.9 ± 9.8 h for heterozygous EMs and 20.0 ± 10.8 h for homozygous EMs [28] . However, plasma diazepam levels do not always correlate with the sedative effects [29,30] . Moreover, Kosuge et al [16] reported that influences of diazepam on psychomotor functions did not differ among the 3 different CYP2C19 genotype groups, as observed in this study.…”