2. Prescribing points

For conditions such as anxiety and insomnia, a benzodiazepine should be prescribed only if other psychological and behaviour treatments have proved inadequate and the symptoms are severe.
For the treatment of anxiety and insomnia, a benzodiazepine should be given for about two week and a maximum of four weeks.
A benzodiazepine should be avoided in those with a history of substance abuse or with personality disorders.
Benzodiazepine dose in the elderly and the frail should be much lower than the usual adult dose—often about half the adult dose.
To minimise the likelihood of accumulation in the body, a short-acting benzodiazepine may be preferred in the elderly.
Benzodiazepine dose should be reduced in impaired liver or kidney function.
The individual should be advised about CNS depressant effects of benzodiazepines—including ‘hangover’ effects, unsteadiness, reduced alertness, and impaired memory.
It is important to stress to the individual that the use of a benzodiazepine can markedly affect the ability to drive.
The individual should be warned of serious adverse effects if alcohol and other sedative substances are used while taking a benzodiazepine.
To withdraw benzodiazepine treatment, dose reduction should be gradual and the individual properly supported in dealing with the withdrawal effects.