ABSTRACT
Anxiety,tensionandinsomniaareexperiencedacutely,repeatedlyorchronicallyby manypeople.Suchsymptomsaregenerallytreatedbyavarietyofpharmacological andnon-drugmethods.Ofthemedicamentsused,thebenzodiazepineshavebeen regardedbymedicalpractitionersandpatientsalikeassafeandeffective symptomaticremedies.Consequently,prescriptionofbenzodiazepineanxiolytics andhypnoticshassoared,almostcompletelyoustingthebarbituratesandotherolder compounds.Overthepasttenyearsorso,ithasbecomeincreasinglyevidentthat long-termprescriptionofbenzodiazepinesisassociatedwithadefiniteriskof dependenceandthatevenshort-termusemayresultinreboundondiscontinuation.
~THDRAWALSYNDROMES Rebound Reboundinsomniaisaspecifictypeofwithdrawalsleepdisturbance,characterized byaworseningofsleepbeyondpretreatmentlevels,followingabruptdiscontinuationofbenzodiazepinehypnoticswithmediumtorapideliminationrates.It mayoccurevenwhenthedrughasbeenadministeredshort-terminmodestdosage. Ananalogoussyndromemaybeseenafterthewithdrawalofanxiolyticsgivenfora fewweeksonly.Inabruptlydiscontinuedpatients,anxietymayincreasetoan intensityabovethatinthepre-drugperiod.Thisreboundisparticularlymarkedin patientsstoppingmedium-actingcompoundssuchaslorazepam.Taperingthedose shouldberegardedasgoodclinicalpracticeevenwhenthebenzodiazepinehasbeen administeredforashortcourseoftreatment.
