Abuse and Dependence Liability of Benzodiazepine-type Drugs: GABA(A) Receptor Modulation and Beyond

Overview

Journal Pharmacol Biochem Behav

Publisher Elsevier

Specialties Biochemistry
Pharmacology
Psychology
Social Sciences

Date 2008 Feb 26

PMID 18295321

Citations 67

Authors

Stephanie C Licata

James K Rowlett

Affiliations

Soon will be listed here.

Abstract

Over the past several decades, benzodiazepines and the newer non-benzodiazepines have become the anxiolytic/hypnotics of choice over the more readily abused barbiturates. While all drugs from this class act at the GABA(A) receptor, benzodiazepine-type drugs offer the clear advantage of being safer and better tolerated. However, there is still potential for these drugs to be abused, and significant evidence exists to suggest that this is a growing problem. This review examines the behavioral determinants of the abuse and dependence liability of benzodiazepine-type drugs. Moreover, the pharmacological and putative biochemical basis of the abuse-related behavior is discussed.

Citing Articles

GABAergic compounds for the treatment of alcohol use disorder.

Berro L, Rowlett J, Platt D Int Rev Neurobiol. 2024; 178:383-399.

PMID: 39523061 PMC: 11611293. DOI: 10.1016/bs.irn.2024.08.001.

Onset of Prolonged High-Potency Benzodiazepine Use Among ICU Survivors: A Nationwide Cohort Study.

Lindstrom A, von Oelreich E, Eriksson J, Eriksson M, Martensson J, Larsson E Crit Care Explor. 2024; 6(7):e1124.

PMID: 38984149 PMC: 11233102. DOI: 10.1097/CCE.0000000000001124.

Abuse potential assessment of the dual orexin receptor antagonist daridorexant in rats.

Steiner M, Toeroek-Schafroth M, Giusepponi M, Dacome L, Tessari M J Psychopharmacol. 2023; 37(12):1249-1260.

PMID: 38059356 PMC: 10714714. DOI: 10.1177/02698811231215415.

Defining Prescription Drug Misuse: A Naturalistic Evaluation of National Survey on Drug Use and Health Data From 2012-2014 to 2015-2017.

McHugh R, Votaw V, McCarthy M, Bichon J, Bailey A, Fitzmaurice G J Addict Med. 2023; 17(3):326-332.

PMID: 37267178 PMC: 10248189. DOI: 10.1097/ADM.0000000000001115.

Behavioral effects of triazolam and pregnanolone combinations: reinforcing and sedative-motor effects in female rhesus monkeys.

Cook J, Platt D, Ruedi-Bettschen D, Rowlett J Front Psychiatry. 2023; 14:1142531.

PMID: 37252149 PMC: 10213563. DOI: 10.3389/fpsyt.2023.1142531.

References

Van Sickle B, Xiang K, Tietz E . Transient plasticity of hippocampal CA1 neuron glutamate receptors contributes to benzodiazepine withdrawal-anxiety. Neuropsychopharmacology. 2004; 29(11):1994-2006. DOI: 10.1038/sj.npp.1300531. View

McMahon L, Gerak L, France C . Potency of positive gamma-aminobutyric acid(A) modulators to substitute for a midazolam discriminative stimulus in untreated monkeys does not predict potency to attenuate a flumazenil discriminative stimulus in diazepam-treated monkeys. J Pharmacol Exp Ther. 2001; 298(3):1227-35. View

Verster J, Volkerts E, Verbaten M . Effects of alprazolam on driving ability, memory functioning and psychomotor performance: a randomized, placebo-controlled study. Neuropsychopharmacology. 2002; 27(2):260-9. DOI: 10.1016/S0893-133X(02)00310-X. View

Depoortere H, Zivkovic B, Lloyd K, Sanger D, Perrault G, Langer S . Zolpidem, a novel nonbenzodiazepine hypnotic. I. Neuropharmacological and behavioral effects. J Pharmacol Exp Ther. 1986; 237(2):649-58. View

Ciraulo D, Sands B, Shader R . Critical review of liability for benzodiazepine abuse among alcoholics. Am J Psychiatry. 1988; 145(12):1501-6. DOI: 10.1176/ajp.145.12.1501. View

Carnevale F, Ducharme C . Adverse reactions to the withdrawal of opioids and benzodiazepines in paediatric intensive care. Intensive Crit Care Nurs. 1997; 13(4):181-8. DOI: 10.1016/s0964-3397(97)80012-2. View

VonVoigtlander P, Lewis R . A rapid screening method for the assessment of benzodiazepine receptor-related physical dependence in mice. Evaluation of benzodiazepine-related agonists and partial agonists. J Pharmacol Methods. 1991; 26(1):1-5. DOI: 10.1016/0160-5402(91)90049-b. View

Gray A, Allison C, Pratt J . A role for AMPA/kainate receptors in conditioned place preference induced by diazepam in the rat. Neurosci Lett. 1999; 268(3):127-30. DOI: 10.1016/s0304-3940(99)00371-7. View

Kamel N, Gammack J . Insomnia in the elderly: cause, approach, and treatment. Am J Med. 2006; 119(6):463-9. DOI: 10.1016/j.amjmed.2005.10.051. View

10.

Hu X, Ticku M . Chronic benzodiazepine agonist treatment produces functional uncoupling of the gamma-aminobutyric acid-benzodiazepine receptor ionophore complex in cortical neurons. Mol Pharmacol. 1994; 45(4):618-25. View

11.

Reynolds J, Maitra R . Propofol and flurazepam act synergistically to potentiate GABAA receptor activation in human recombinant receptors. Eur J Pharmacol. 1996; 314(1-2):151-6. DOI: 10.1016/s0014-2999(96)00527-4. View

12.

Steppuhn K, Turski L . Diazepam dependence prevented by glutamate antagonists. Proc Natl Acad Sci U S A. 1993; 90(14):6889-93. PMC: 47038. DOI: 10.1073/pnas.90.14.6889. View

13.

Atack J, Wafford K, Tye S, Cook S, Sohal B, Pike A . TPA023 [7-(1,1-dimethylethyl)-6-(2-ethyl-2H-1,2,4-triazol-3-ylmethoxy)-3-(2-fluorophenyl)-1,2,4-triazolo[4,3-b]pyridazine], an agonist selective for alpha2- and alpha3-containing GABAA receptors, is a nonsedating anxiolytic in rodents and primates. J Pharmacol Exp Ther. 2005; 316(1):410-22. DOI: 10.1124/jpet.105.089920. View

14.

Metzger D, Woody G, De Philippis D, McLellan A, OBrien C, Platt J . Risk factors for needle sharing among methadone-treated patients. Am J Psychiatry. 1991; 148(5):636-40. DOI: 10.1176/ajp.148.5.636. View

15.

Souza-Pinto L, Castilho V, Brandao M, Nobre M . The blockade of AMPA-kainate and NMDA receptors in the dorsal periaqueductal gray reduces the effects of diazepam withdrawal in rats. Pharmacol Biochem Behav. 2007; 87(2):250-7. DOI: 10.1016/j.pbb.2007.04.021. View

16.

Wafford K . GABAA receptor subtypes: any clues to the mechanism of benzodiazepine dependence?. Curr Opin Pharmacol. 2005; 5(1):47-52. DOI: 10.1016/j.coph.2004.08.006. View

17.

Cammarano W, Pittet J, Weitz S, Schlobohm R, Marks J . Acute withdrawal syndrome related to the administration of analgesic and sedative medications in adult intensive care unit patients. Crit Care Med. 1998; 26(4):676-84. DOI: 10.1097/00003246-199804000-00015. View

18.

Smith A, Alder L, Silk J, Adkins C, Fletcher A, Scales T . Effect of alpha subunit on allosteric modulation of ion channel function in stably expressed human recombinant gamma-aminobutyric acid(A) receptors determined using (36)Cl ion flux. Mol Pharmacol. 2001; 59(5):1108-18. DOI: 10.1124/mol.59.5.1108. View

19.

Jaffe J, Bloor R, Crome I, Carr M, Alam F, Simmons A . A postmarketing study of relative abuse liability of hypnotic sedative drugs. Addiction. 2004; 99(2):165-73. DOI: 10.1111/j.1360-0443.2003.00631.x. View

20.

Drake S, Swift W, Hall W, ROSS M . Drug use, HIV risk-taking and psychosocial correlates of benzodiazepine use among methadone maintenance clients. Drug Alcohol Depend. 1993; 34(1):67-70. DOI: 10.1016/0376-8716(93)90047-t. View