Table 28. Benzodiazepines (e.g., Diazepam, Clonazepam, Alprazolam): Overview.

Efficacy	Generalized anxiety (FDA approved)
	Panic disorder (FDA approved for alprazolam, clonazepam)
	Insomnia (FDA approved)
	Seizure disorder (FDA approved for clonazepam)
	Muscle relaxation
	Anesthesia
	Alcohol withdrawal
Side effects	Sedation
	Lethargy
	Dependence/Withdrawal
Safety in overdose	Safe in overdose up to 30 times the normal daily dose. Usual symptoms of overdose include sedation, drowsiness, ataxia, and slurred speech. May result in respiratory depression in combination with other CNS depressants. Management includes gastric lavage, forced emesis, and assisted ventilation.
Dosage and administration	Varies by benzodiazepine and indication; see Table 6–1.
Discontinuation	Taper by no more than 25% of total dose per week after long-term administration. Withdrawal includes insomnia, agitation, anxiety, and, rarely, seizures.
Drug interactions	Additive CNS depression with ethanol, barbiturates, and other CNS depressants
	Drugs that ↑ triazolo-benzodiazepine levels include; cytochrome P450 3A4 inhibitors, ketoconazole, fluconazole, nefazodone
	Drugs that ↓ triazolo-benzodiazepine levels include: carbamazepine

Note: CNS = central nervous system; FDA = U.S. Food and Drug Administration.