The Role of Benzodiazepines in the Treatment of Posttraumatic Stress Disorder (PTSD)

Author’s Address: Nancy C. Bernardy, Ph.D., is affiliated with the National Center for PTSD, Department of Veterans Affairs, White River Junction, VT 05009, and the Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH. Email Address: [email protected]. Benzodiazepines were introduced in the 1960’s to replace barbiturates, which were effective as sedatives but were dangerous in overdosage and often abused. The stress-reducing and sedating properties of benzodiazepines made them seemingly an ideal drug to manage anxiety and insomnia symptoms and they became useful in addressing other clinical states such as epilepsy, spasmodic disorders, alcohol withdrawal, and anesthesia. Benzodiazepines rapidly became the most widely used of all psychotropic drugs; during the last 25 years it has been estimated that over 500 million people have taken a course of benzodiazepine treatment. Historically benzodiazepines were the primary posttraumatic stress disorder (PTSD) treatment agent and their anxiety-reducing properties made them seem to be a model medication for the management of symptoms related to PTSD. Soon after the development of benzodiazepines, however, reports began to appear about potential withdrawal symptoms and risks of tolerance and dependence, which contributed to the continued controversy surrounding their use (for a historical review, see Lader, 2011).