eMJA: Norman et al., Benzodiazepines in anxiety disorders: Box 2

Norman et al,
Box 2

Commonly used benzodiazepines, half-lives, age effects and indications for use


		Range of daily doses (mg)		Elimination half-life (hours)
Drug	Usual indication	Young, healthy	Elderly	Elimination half-life (hours)	Effects of increasing age

Long elimination half-life
Clobazam	Anxiety, panic attacks*	30-80	10-20	12-60	Elimination half-life decreased
Diazepam	Anxiety, panic attacks*	6-80	2-40	20-90	Elimination half-life increased
Flurazepam	Insomnia	15-60	15-30	40-100	Toxicity increased
Intermediate elimination half-life
Alprazolam	Anxiety, panic attacks*	1-4	0.25-1	6-20	Elimination half-life decreased
Flunitrazepam	Insomnia	0.5-2	0.5-2	20-30	Little effect
Lorazepam	Anxiety	2-4	2-4	10-20	Little effect
Nitrazepam	Insomnia	5-20	5-10	20-30	Elimination half-life increased
Oxazepam	Anxiety	45-90	15-30	4-14	No effect
Temazepam	Insomnia	10-30	10-20	8-22	Little effect
Short elimination half-life
Triazolam	Insomnia	0.5-2	0.5-1	5-10	Elimination half-life increased
*The doses used for the control of panic attacks may need to be higher than those for other anxiety states (e.g., 6-10 mg/day of alprazolam to control panic disorder is not uncommon).

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