Abstinence symptoms after withdrawal of tranquillising drugs: is there a common neurochemical mechanism?

Lancet. 1982 Aug 14;2(8294):360-2. doi: 10.1016/s0140-6736(82)90550-5.

Abstract

Withdrawal of anxiolytic agents such as ethanol, barbiturates, and benzodiazepines may result in a syndrome characterised in its most severe form by delirium and seizures. There is increasing evidence that anxiolytic drugs produce their pharmacological effects by enhancing brain gamma-aminobutyric acid (GABA) transmission. During long-term exposure to anxiolytics, brain GABA synapses show evidence of adaptive changes which would tend to reduce the effect of the anxiolytic and restore normal GABA function. Abrupt cessation of anxiolytic treatment might therefore lead to an acute reduction in GABA function; this change could underlie the severe symptoms associated with tranquilliser withdrawal.

MeSH terms

  • Anti-Anxiety Agents / adverse effects*
  • Delirium / physiopathology
  • GABA Antagonists*
  • Humans
  • Models, Biological*
  • Receptors, Cell Surface / physiology
  • Seizures / etiology
  • Seizures / physiopathology
  • Substance Withdrawal Syndrome / etiology
  • Substance Withdrawal Syndrome / physiopathology*
  • Synaptic Transmission
  • gamma-Aminobutyric Acid / physiology

Substances

  • Anti-Anxiety Agents
  • GABA Antagonists
  • Receptors, Cell Surface
  • gamma-Aminobutyric Acid