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Tranquilizer/Anxiolytics: Benzodiazepines (Intermediate-Acting) – Alprazolam, Bromazepam, Clonazepam, Lorazepam

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NeuroPsychopharmacotherapy

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Abstract

The first discovered benzodiazepine (chlordiazepoxide) was developed serendipitously by Leo Henryk Sternbach working for the Hoffmann-LaRoche Inc. in 1955 and made available as Librium in 1955. Benzodiazepines are often classified by duration of action and this chapter will review intermediate acting Alprazolam, Bromazepam, Clonazepam, and Lorazepam. These drugs are metabolized by the hepatic Cytochrome P450 family of enzymes with varying degree of hepatic glucuronidation. The mechanism of action is through various benzodiazepine receptors on the GABA receptor distributed in various regions of the central nervous system (CNS). The location of the GABA receptor in the CNS and the degree to which benzodiazepine drug binds to each receptor contributes to the overall differential effects of each medication. These medications are marketed and recommended generally as second line treatments or augmentation agents for various anxiety disorders such as generalized anxiety disorder, panic disorder, and social anxiety disorder. Benzodiazepines interact with or may potentiate the effects of other CNS-acting drugs such as alcohol, narcotics, barbiturates, nonbarbiturate hypnotics, antihistamines, phenothtazines, butyrophenones, monoamine oxidase inhibitors, tricyclic antidepressants, and anti-convulsants. There is high risk of dependency and withdrawal syndromes with long-term use.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Brett D. M. Jones

  2. Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada

    M. Ishrat Husain

Authors
  1. Brett D. M. Jones
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  2. M. Ishrat Husain
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Correspondence to Brett D. M. Jones .

Editor information

Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Stefan Kloiber

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Jones, B.D.M., Husain, M.I. (2022). Tranquilizer/Anxiolytics: Benzodiazepines (Intermediate-Acting) – Alprazolam, Bromazepam, Clonazepam, Lorazepam. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_407

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  • DOI: https://doi.org/10.1007/978-3-030-62059-2_407

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-62058-5

  • Online ISBN: 978-3-030-62059-2

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