Benzodiazepine Clinical Uses

Summary

Benzodiazepines are drugs with a wide range of clinical uses.

They are used as broad-spectrum antiepileptics to treat a wide range of seizures, including both generalized and focal seizures. They are also the first-line treatment for status epilepticus.

Benzodiazepines may be used to treat acute panic attacks in panic disorder, alcohol withdrawal including delirium tremens, eclampsia, spasticity, and other anxiety disorders.

As sedative-hypnotics, benzodiazepines are used to treat insomnia. They can also be used to treat sleep disorders like sleepwalking and night terrors. Their sedative and anxiety-reducing properties are also useful for inducing general anesthesia before surgery.

Key Points

• Clinical Uses of Benzodiazepines
  • Treats seizures (antiepileptic)
    • Broad spectrum effects
      • Treats focal (partial) seizures
      • Treats generalized (tonic-clonic) seizures
  • Treat status epilepticus
    • IV lorazepam is 1st line, then diazepam and midazolam
    • High efficacy and rapid onset of action for acute seizures
  • Treat eclampsia
    • IV diazepam is 2nd line after magnesium sulfate
  • Treat alcohol withdrawal (delirium tremens)
    • Lorazepam and diazepam are both 1st line agents
    • Lorazepam preferred in severe liver disease (no active metabolites)
      • Diazepam has active liver metabolites, which can accumulate and cause toxicity
  • Treat anxiety
    • Can be used to treat generalized anxiety and other anxiety disorders
  • Treat panic disorder
  • Treat spasticity (muscle spasms)
    • Works as a muscle relaxant
  • Used for general anesthesia
    • Induces amnesia and muscle relaxation
  • Treat insomnia (sedative-hypnotic)
    • May be used for treatment of insomnia
      • Note: decreases REM sleep
  • Treats night terrors
  • Treats sleepwalking