General practice & prim · UKMLA & AKT
Benzodiazepine dependence
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise benzodiazepine dependence — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Benzodiazepines potentiate GABA at GABA-A receptors - increase frequency of chloride channel opening, increasing CNS inhibitory tone
- Prolonged use causes downregulation of GABA-A receptors and compensatory upregulation of excitatory (glutamate/NMDA) transmission - CNS depends on drug being present
- On cessation/dose reduction: unmasked CNS hyperexcitability = withdrawal syndrome (same mechanism as alcohol withdrawal)
- Dependence can develop within 4-6 weeks at therapeutic doses - patients need never have exceeded prescribed quantities
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