Regardless of their potency, speed of elimination or duration of effects, the actions in the body are virtually the same for all benzodiazepines. This is true whether they are marketed as anxiolytics, hypnotics or anti-convulsants. Benzodiazepines exert five major effects which are used therapeutically: anxiolytic, hypnotic, muscle relaxant, anticonvulsant and amnesic (impairment of memory).
Therapeutic use of benzodiazepines:
- Anxiolytic relief of anxiety - Anxiety and panic disorders, phobias
- Hypnotic - promotion of sleep - Insomnia
- Myorelaxant - muscle relaxation - Muscle spasms, spastic disorders
- Anticonvulsant - stop fits, convulsions - Fits due to drug poisoning, some forms of epilepsy
- Amnesia - impair short-term memory - Premedication for operations, sedation for minor surgical procedures
Other clinical uses, utilising combined effects:
- Alcohol detoxification
- Acute psychosis with hyperexcitability and agressiveness
These actions, exerted by different benzodiazepines in slightly varying degrees, confer on the drugs some useful medicinal properties. Few drugs can compete with them in efficacy, rapid onset of action and low acute toxicity. In short-term use, benzodiazepines can be valuable, sometimes even life-saving, across a wide range of clinical conditions. Nearly all the disadvantages of benzodiazepines result from long-term use (regular use for more than a few weeks). The UK Committee on Safety of Medicines in 1988 recommended that benzodiazepines should in general be reserved for short-term use (2-4 weeks only).