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.
Similar content being viewed by others
References
Pelissolo A, Boyer P, Lepine JP, et al: Epidemiology of the use of anxiolytics and hypnotic drugs in France and in the world. Encephale 22(3):187–196, 1996.
Howes JB, Ryan J, Fairbrother G, et al: Benzodiazepine prescribing in a Sydney bteaching hospital. Medical journal of Australia 165(6):305–308, 1996.
Zito JM. Safer DJ. DosReis S, et al: Psychotropic practice patterns for youth: A 10-year perspective. Archives of Pediatrics & Adolescent Medicine. 157:17–25, 2003.
Simeon JG, Ferguson HB: Recent developments in the use of antidepressant and anxiolytic medications. Psychiatr Clin North Am 8:893–907, 1985.
Salzman C: Benzodiazepine dependency: Summary of the APA task force on benzodiazepines Psychopharmacol Bull 26:61–62, 1990.
Janicak PG (ed): Principles and Practice of Psychopharmacotherapy, 3rd ed. PhiladelphiaLippincott Williams and Wilkins 471–474, 2001.
Greenblatt DJ, Shader RI: Benzodiazepines in clinical practice. New York, Raven Press, 1974.
Coffey BJ: Anxiolytics for children and adolescents: Traditional and new drugs. J Child Adolesc Psychopharmacol 1:57–86, 1990.
Campbell M, Green WH, Deutsch SI: Child and adolescent psychopharmacology. Beverly Hills, CA: Sage, vol 10, 1985.
Chebib M, Johnston GA: The ABC of GABA receptors: A brief review: Clin Exp Pharmacol Physiol 26:937–940, 1999.
Low K, Crestani F, Keist R, et al: Molecular and neuronal substrate for the selective attenuation of anxiety Science 290:131–138, 2000.
Polk P: Electrophysiology of benzodiazepine receptor ligands: Multiple mechanisms and sites of action. Prog Neurobiol 31:349–423, 1988.
Hobbs WR, Rall TW, Verdoorn TA: Goodman and Gillman’s The Pharmacological Basis of Therapeutics, 9th ed. Edited by Hardman JG, Limbird LE, Molinoff PB, Ruddon RW, Gilman AG. New York, McGraw-Hill, 361–396, 1996.
Graae F, Milner J, Rizzotto L: Clonazepam in childhood anxiety disorders. J. Am Acad Child Adolesc Psychiatry 33:372–376, 1994.
Biederman J: Clonazepam in the treatment of prepubertal children with panic like symptoms. J. Clin. Psychiatry 48(Supplement):38–41, 1987.
D’Amato G: Chlordiazepoxide in Management of school phobia. Dis Nerv Sys 23:292–295, 2001.
Green WH: Child and Adolescent Clinical Psychopharmacology. 3rd ed. Philadelphia, Lippincot Williams & Wilkins, 2001.
Simeon JG, Ferguson HB: Alprazolam effects in children with anxiety disorders. Can J Psychiatry 32:570–574, 1987.
Pfefferbaum G, Overall JE, Boren HA, et al: Treatment of anticipatory and acute situational anxiety in children with cancer. J Am Acad Child and Adolescent Psychiatry 26:532–535, 1987.
Klein RG, Last CG: Anxiety disorders in children. Newbury Park, CA: Sage, 1989.
Simeon JG, Ferguson HB. Knott V, et al: Clinical, cognitive, and neurophysiological effects of alprazolam in children and adolescents with overanxious and avoidant disorder. J Am Acad Child and Adolescent Psychiatry 31:29–33, 1992.
Bernstein GA, Garfinkel BD, Borchardt CM: Comparative studies of pharmacotherapy for school refusal. J. Am. Acad Child Adolescent Psychiatry 29:773–781, 1990.
PDR Physicians Desk Reference, 58th ed. Montvale, New Jersey, Thompson, 2004.
Kraft IA, Adrall C, Duffy JH, Hart JT, et al: Pearce P. A clinical study of chlordiazepoxide used in psychiatric disorders in children. Int J of Neuropsychiatry 1: 433–437, 1965.
Kutcher SP, MacKenzie S: Successful clonazepam treatment of adolescents with panic disorder. J. Clin Psychopharmacologic 8:299–301, 1988.
Johns MW: Sleep and hypnotic drugs, Drugs 9(6):448–478, 1975.
Oswald I: The mechanism of sleep disorders: some recent advances. Journal of Neurology 5:187–194, 1965.
Popoviciu L, Corfariu O: Efficacy and safety of midazolam in the treatment of night terrors in children. Brit. J of clin Pharmacol 16(Suppl 1):97S–102S, 1983.
Garza-Trevino et al: Efficacy of combinations of IM antipsychotic and sedative-hypnotics for control of psychotic agitation. Am J. Psychiatry, 146:1598–1601, 1989.
Bieniek SA, Ownby RL, Penalver A, et al: A double blind study of lorazepam versus the combination of haloperidol and lorazepam in managing agitation. Pharmacotherapy 18:57–62, 1998.
Barnett S, Riddle M: Anxiolytics, benzodiazepines, buspirone and others, in Pediatric Psychopharmacology. Principles and Practice, Edited by Martin A, Scahill L, Charney D, Leckman JF. New York, Oxford University Press, 2003.
Gleser GD, Gottschack LA, Fox R, et al: Immediate changes in affect with chlordiazepoxide. Arch Gen Psychiatry 13:291–295, 1965.
Bond WS, Mandos LA, Kurtz MB: Midazolam for aggressivity and violence in three mentally retarded patients. AMJ Psychiatry 146:925–926, 1989.
Petti TA, Fish B, Shapiro T, et al: Effects of chlordiazepoxide in disturbed children: A pilot study. J Clin Psychopharmacol 2:270–273, 1982.
Campbell M, Gonzalez NM, Silva RR: The pharmacologic treatment of conduct disorders and rage outbursts. Psych Clinics of N Am 15(1):69–85, 1992.
Sorrentino A: Chemical restraints for the agitated, violent, or psychotic pediatric patient in the emergency department: Controversies and recommendations. Current Opinion in Pediatrics. 16(2):201–205, 2004.
Tamara M, Rein TP: Anaesthetic premedications: Aims, assessment and methods. Can J Anaesth 34(3):259–273, 1987.
Martinez-Aguirre E, Sansano C: Comparison of midazolam and diazepam as complement of ketamine-air anesthesia in children. Acta Anaesth Belgica 37(1):15–21, 1986.
Vininng EPG: Use of barbiturates and Benzodiazepines in Treatment of Epilepsy. Neurologic Clinics 4 (3):617–631, 1986.
Chien C, Keegan D: Diazepam as an oral long-term anticonvulsant for epileptic mental patients. Dis Nerv Syst 33:100–104, 1972.
Hanhan UA, Fiallos MR, Orlowski JP: Status epilepticus. Pediatric Clinics of North America 48(3):683–692, 2001.
Mahmoudian T, Mohammadi Zadeh M: Comparison of intranasal midazolam with intravenous diazepam for treating acute seizures in children. Epilepsy and Behavior 5:253–255, 2004.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Witek, M.W., Rojas, V., Alonso, C. et al. Review of Benzodiazepine use in Children and Adolescents. Psychiatr Q 76, 283–296 (2005). https://doi.org/10.1007/s11126-005-2982-5
Issue Date:
DOI: https://doi.org/10.1007/s11126-005-2982-5