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Long-acting benzodiazepines with long-acting active metabolites, such as diazepam and chlordiazepoxide, are often prescribed for benzodiazepine or alcohol withdrawal as well as for anxiety if constant dose levels are required throughout the day. Shorter-acting benzodiazepines are often preferred for insomnia due to their lesser hangover effect.
Rebound insomnia, however, is more common upon discontinuation of intermediate-acting benzodiazepines than longer-acting benzodiazepines. Examples are alprazolam, estazolam, flunitrazepam, clonazepam, lormetazepam, lorazepam, nitrazepam, and temazepam. Long-acting compounds have a half-life of 40–250 hours.
Diazepam is a long-acting "classical" benzodiazepine. Other classical benzodiazepines include chlordiazepoxide, clonazepam, lorazepam, oxazepam, nitrazepam, temazepam, flurazepam, bromazepam, and clorazepate. [101] Diazepam has anticonvulsant properties. [102]
Clorazepate is a long-acting benzodiazepine drug. [10] Clorazepate produces the active metabolite desmethyl-diazepam , which is a partial agonist of the GABA A receptor and has a half life of 20–179 hours; a small amount of desmethyldiazepam is further metabolised into oxazepam .
Temazepam is a short-acting benzodiazepine and hypnotic. [8] [7] It works by affecting GABA within the brain. [8] Temazepam was patented in 1962 and came into medical use in 1969. [12] It is available as a generic medication. [13] In 2021, it was the 208th most commonly prescribed medication in the United States, with more than 2 million ...
Nitrazepam is a long-acting benzodiazepine with a risk of drug accumulation, though no active metabolites are formed during metabolism. Accumulation can occur in various body organs, including the heart; accumulation is even greater in babies. Nitrazepam rapidly crosses the placenta and is present in breast milk in high quantities.
Flurazepam is a long-acting benzodiazepine and is sometimes used in patients who have difficulty in maintaining sleep, though benzodiazepines with intermediate half-lives such as loprazolam, lormetazepam, and temazepam are also indicated for patients with difficulty maintaining sleep.
Sonata – a non-benzodiazepine hypnotic; Spravato – a rapid-acting antidepressant of the NMDA receptor antagonist class; enantiomer of ketamine; Stelazine (trifluoperazine) – an antipsychotic used in the treatment of psychotic disorders, anxiety, and nausea caused by chemotherapy [2]