Disinhibitory reactions to benzodiazepines: A review

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dc.contributor.authorVan der Bijl P.
dc.contributor.authorRoelofse J.A.
dc.date.accessioned2011-05-15T16:02:01Z
dc.date.available2011-05-15T16:02:01Z
dc.date.issued1991
dc.description.abstractThis article reviews some of the important aspects of benzodiazepine-induced disinhibitory reactions. Although reactions of this type are relatively rare, they may sometimes manifest themselves in aggressive behavior accompanied by suicidal or homicidal tendencies. It appears that these reactions occur more commonly in younger patients, although the elderly (above 65 years) may also be at risk. Many mechanisms have been postulated, but none truly explain how these reactions arise. The concept that central cholinergic mechanisms may play a role, however, remains attractive and stems primarily from physostigmine's ability to successfully reverse this type of reaction. The potential role of the benzodiazepine antagonists, eg, flumazenil, in reversing disinhibitory reactions is also discussed. Apart from patients who previously exhibited poor impulse control, there are no reliable indicators for recognizing potential candidates for this type of reaction. To minimize the occurrence of disinhibitory reactions, some guidelines, which include the avoidance of certain drug combinations, the use of low doses of benzodiazepines, slow incremental intravenous administration, and good rapport with patients, are presented.
dc.description.versionReview
dc.identifier.citationJournal of Oral and Maxillofacial Surgery
dc.identifier.citation49
dc.identifier.citation5
dc.identifier.issn2782391
dc.identifier.urihttp://hdl.handle.net/10019.1/12270
dc.subjectalprazolam
dc.subjectbenzodiazepine
dc.subjectdiazepam
dc.subjectflumazenil
dc.subjectmidazolam
dc.subjectphysostigmine
dc.subjectaggression
dc.subjectagitation
dc.subjectanesthesiology
dc.subjectbehavior disorder
dc.subjectdental surgery
dc.subjectdepression
dc.subjectpriority journal
dc.subjectpsychosis
dc.subjectreview
dc.subjectsedation
dc.subjectside effect
dc.subjectAggression
dc.subjectAnimal
dc.subjectBenzodiazepines
dc.subjectFlumazenil
dc.subjectHuman
dc.titleDisinhibitory reactions to benzodiazepines: A review
dc.typeReview
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