Review of Benzodiazepine use in Children and Adolescents

Abstract

Clinically, benzodiazepines are used in adult populations much more frequently than in children and adolescents. There may be a number of reasons for this disparity including a dearth of well controlled clinical studies and the issue of dependence associated with long term use. However, over a ten year span there has been nearly a three fold increase in the use patterns for these agents in the child population. In open studies much of the literature has indicated potentially useful results, but these findings have not been replicated when more refined methodological studies have been conducted. The lack of encouraging results in these later studies may be attributable to a number of factors such as modest sample sizes and less than optimal patient selection. Nonetheless, with increasing prescriptions being written for these agents it is not clear what is compelling clinicians to use them. In this paper we will review the available literature on benzodiazepine use in the child and adolescent population, focusing primarily on psychiatric applications.

Sport-related Performance Anxiety in Young Female Athletes

“…108 Benzodiazepines Benzodiazepines (BDZs, Table 9) can be used to treat the short-term effects and somatic symptoms before a stage performance but because of their side effects, BDZs are not the medications of choice for sportrelated anxiety. 115,116 Their use is limited to short-term treatment in patients with severe anxiety symptoms for rapid effects before the effects of psychotherapy or SSRIs can be achieved. BZDs are often used for procedure-related anxiety.…”

“…BZDs are often used for procedure-related anxiety. 108,115 BDZs bind to the benzodiazepine receptors in the central nervous system at the gamma aminobutyric acid-A (GABA-A) ligand-gated chloride channel complex and enhance the inhibitory effects of GABA. BDZs facilitate the chloride conductance through GABA-regulated channels.…”

“…108,112,115 Higher dose and longer duration of treatment increase the risk of side effects. BZDs are potentially habit forming and can lead to addiction and dependence.…”

A case of severe adolescent obsessive-compulsive disorder treated with inpatient hospitalization, risperidone and sertraline

“…Benzodiazepines also do not carry the significant long-term side effects associated with antipsychotics including weight gain, dystonia, extrapyramidal symptoms and metabolic syndrome. Although several anecdotal and open-label studies have demonstrated benzodiazepines to be useful in treating obsessive-compulsive disorder (Bodkin & White, 1989;Tesar & Jenike, 1984) or anxiety disorders in children and adolescents (Biederman, 1990;Simeon & Ferguson, 1987), these findings have not been consistently replicated when more structured studies have been performed (Witek, Rojas, Alonso, Minami & Silva, 2005). Two double-blind, placebo-controlled studies failed to show that clonazepam was beneficial in treating symptoms of OCD either as monotherapy (Hollander et al, 2003) or in conjunction with sertraline (Crockett, Churchill & Davidson, 2004).…”

Prescription Drug Abuse among U.S. Adolescents: What Nurses Should Know

“…Prescriptions for benzodiazepines to youth increased 2.8-fold between 1987 and 1996 to an average of 5 per 1000 (Zito et al, 2003). A review of the literature on prescriptions for benzodiazepines in the treatment of psychiatric disorders among children and adolescents finds an increase in prescription rates despite a lack of rigorously designed studies assessing this treatment in non-adult populations (Witek et al, 2005).…”