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Bridging the gap between education and appropriate use of benzodiazepines in psychiatric clinical practice. 2015

Bernardo Dell'Osso, and Umberto Albert, and Anna Rita Atti, and Claudia Carmassi, and Giuseppe Carrà, and Fiammetta Cosci, and Valeria Del Vecchio, and Marco Di Nicola, and Silvia Ferrari, and Arianna Goracci, and Felice Iasevoli, and Mario Luciano, and Giovanni Martinotti, and Maria Giulia Nanni, and Alessandra Nivoli, and Federica Pinna, and Nicola Poloni, and Maurizio Pompili, and Gaia Sampogna, and Ilaria Tarricone, and Sarah Tosato, and Umberto Volpe, and Andrea Fiorillo

Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy ; Bipolar Disorders Clinic, Stanford Medical School, Stanford University, CA, USA.

More than half a century after their discovery, benzodiazepines (BDZs) still represent one of the largest and most widely prescribed groups of psychotropic compounds, not only in clinical psychiatry but also in the entire medical field. Over the last two decades, however, there has been an increased focus on the development of antidepressants and antipsychotics on the part of the pharmaceutical industry, clinicians, and researchers, with a reduced interest in BDZs, in spite of their widespread clinical use. As a consequence, many psychiatric residents, medical students, nurses, and other mental health professionals might receive poor academic teaching and training regarding these agents, and have the false impression that BDZs represent an outdated chapter in clinical psychopharmacology. However, recent advances in the field, including findings concerning epidemiology, addiction risk, and drug interactions, as well as the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition with related diagnostic changes, strongly encourage an updated appraisal of the use of BDZs in clinical practice. During a recent thematic event convened with the aim of approaching this topic in a critical manner, a group of young Italian psychiatrists attempted to highlight possible flaws in current teaching pathways, identify the main clinical pros and cons regarding current use of BDZs in clinical practice, and provide an updated overview of their use across specific clinical areas and patient populations. The main results are presented and discussed in this review.