2. Prescribing points
- For conditions such as anxiety and insomnia, a benzodiazepine should be prescribed only if other psychological and behaviour treatments have proved inadequate and the symptoms are severe.
- For the treatment of anxiety and insomnia, a benzodiazepine should be given for about two week and a maximum of four weeks.
- A benzodiazepine should be avoided in those with a history of substance abuse or with personality disorders.
- Benzodiazepine dose in the elderly and the frail should be much lower than the usual adult dose—often about half the adult dose.
- To minimise the likelihood of accumulation in the body, a short-acting benzodiazepine may be preferred in the elderly.
- Benzodiazepine dose should be reduced in impaired liver or kidney function.
- The individual should be advised about CNS depressant effects of benzodiazepines—including ‘hangover’ effects, unsteadiness, reduced alertness, and impaired memory.
- It is important to stress to the individual that the use of a benzodiazepine can markedly affect the ability to drive.
- The individual should be warned of serious adverse effects if alcohol and other sedative substances are used while taking a benzodiazepine.
- To withdraw benzodiazepine treatment, dose reduction should be gradual and the individual properly supported in dealing with the withdrawal effects.
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