Benzodiazepine Dependence: Clinical and Molecular Aspects, Preventive Strategies and Therapeutic Approaches.
Level 5 - mechanism / opinion, no new human data
Narrative review summarizing pharmacology, mechanisms, and management without systematic search or meta-analysis
PubMed 41683852 · doi:10.3390/ijms27031430
What was done
The authors conducted an expert narrative review compiling recent literature on benzodiazepine pharmacology, clinical indications, adverse effects, and misuse. The review details the neurobiological mechanisms underlying tolerance and benzodiazepine use disorder, alongside preventive and clinical management strategies.
What was found
The abstract reports no numerical data or quantitative effect sizes. It describes the primary pharmacological mechanism as positive allosteric modulation of GABA-A receptors, leading to tolerance and physical dependence via GABA-A subunit downregulation and compensatory sensitization of glutamatergic systems. Recommended clinical management comprises psychological interventions combined with substitution to a long-acting benzodiazepine and gradual tapering. Prevention emphasizes short-term prescribing, lowest effective doses, and alternative agents such as SSRIs or SNRIs.
Why it matters
This review synthesizes the molecular basis of benzodiazepine dependence with clinical guidance on risk mitigation, substitution, and tapering strategies for healthcare providers.
Limits
This is a narrative expert review lacking systematic literature search criteria, study quality grading, and meta-analytic pooling. The abstract provides no primary human data, sample sizes, or quantitative comparisons of tapering protocol efficacy.
Cited by
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