Risks of dependence on benzodiazepine drugs: a major problem of long term treatment.

Phlegmatic people dislike taking benzodiazepine drugs. In those with low'anxiety traits benzodiazepines are dysphoric and may paradoxically increase anxiety.' In normal subjects benzodiazepines improve performance under experimental stress but worsen it under conditions of low stress.2 Benzodiazepines relieve preoperative anxiety in patients with high anticipatory anxiety but not in those with low anticipatory anxiety.3 Thus like 0i receptor blocking agents benzodiazepines require some underlying tone upon which to exert their anxiolytic effects. In general, the greater the anxiety the greater the anxiolytic efficacy. It follows that most people who take benzodiazepines are anxious. In students a history of prescribed benzodiazepines correlates with a high anxiety trait.4 Long term users likewise have high scores for neuroticism. 6 These findings apply when benzodiazepines are used both as anxiolytic and as hypnotic agents. Thus people who take and keep on taking benzodiazepines are a self selected population with high anxiety traits or states.