Abstract
Benzodiazepines are the most widely prescribed central nervous system (CNS) depressants in the United States. They have been in use since the 1960s as anxiolytics, anticonvulsants, and muscle relaxants. The name of the class is derived from the combination of a benzene ring with a seven-membered diazepine ring. Included in the structure is a phenyl ring attached to the 5-position of the diazepine, a requirement for benzodiazepine activity. Benzodiazepines mediate their CNS-depressant activity through the neurotransmitter gamma-amino butyric acid (GABA), the major inhibitory neurotransmitter in the brain. Benzodiazepines bind to GABAA receptors and potentiate the inhibitory action of GABA. Benzodiazepines have a high therapeutic index and, as a result, rarely cause death by themselves. In addition to the widely prescribed benzodiazepines such as alprazolam, clonazepam, diazepam, and lorazepam, a number of analogs have been developed illicitly, including pyrazolam, flubromazolam, and others. Analysis of benzodiazepines often requires the inclusion of metabolites, depending on the specimen being tested. The chemistry, pharmacology, effects, and analysis of therapeutic and designer benzodiazepines are reviewed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Baselt RC (2020) Disposition of toxic drugs and chemicals in man, 12th edn. Biomedical Publications, Seal Beach, CA
Hoiseth G, Skogstad S, Karinen R (2016) Blood concentrations of new designer benzodiazepines in forensic cases. Forensic Sci Int 268:35–38
Howard P, Twycross R, Shuster J, Mihalyo M, Wilcock A (2014) Therapeutic reviews – Benzodiazepines. J Pain Symp Mngt 47:955–967
Kurko TAT, Saastamoinen LK, Tahkapaa S, Tuulio-Henriksson A, Taiminen T et al (2015) Long-term use of benzodiazepines: Definitions, prevalence and usage patterns-a systematic review of register-based studies. Euro Psychiatry 30:1037–1047
Licata SC, Rowlett JK (2008) Abuse and dependence liability of benzodiazepine-type drugs:GABAA receptor modulation and beyond. Pharmacol, Biochem Beh 90:74–89
Manchester KR, Lomas EC, Waters L, Dempsey FC, Maskell PD (2018) The emergence of new psychoactive substance (NPS) benzodiazepines: A review. Drug testing and analysis 10:37–53
Persona K, Madej K, Knihnicki P, Pikoszewski W (2015) Analytical methodologies for the determination of benzodiazepines in biological samples. J Pharm Biomed Anal 113:239–264
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Jufer-Phipps, R.A., Levine, B.S. (2020). Benzodiazepines. In: Levine, B.S., KERRIGAN, S. (eds) Principles of Forensic Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-030-42917-1_20
Download citation
DOI: https://doi.org/10.1007/978-3-030-42917-1_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-42916-4
Online ISBN: 978-3-030-42917-1
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)