General practice & primary care · UKMLA & AKT
Benzodiazepine dependence
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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