Benzodiazepines: selective use to avoid addiction.

Abstract

When judiciously used, benzodiazepines are therapeutically effective and remarkably safe. Long-term use may result in addiction and physical dependence in some patients. The physician's awareness of this risk helps in the prevention of dependence. Four variables play a part in the development of dependence, ie, dose, duration of treatment, the history, and the patient's personality. A dosage higher than the usual therapeutic dose not only is not needed in most patients but produces more side effects. Short term therapy carries a low risk of dependence and is preferred. It is advisable not to use benzodiazepines in patients with a history of alcohol or drug abuse, as dependent personalities pose a higher risk than other personality types.