Benzodiazepines for Anxiety

Lorazepam and diazepam have different half-lives and metabolic profiles, affecting their suitability for acute versus longer-term management. This difference means diazepam accumulates less with once-daily dosing but persists longer in elderly or hepatically impaired patients.

Dependence risk increases with longer duration and higher doses, with more challenging discontinuation profiles observed in longer-term or higher-dose regimens.

Discontinuation strategies vary by agent and patient factors; longer-acting agents may allow less frequent dose reductions, while shorter-acting agents may require more frequent adjustments. Switching to a longer-acting agent like diazepam mid-taper is often prudent for high-dose or rapid-taper scenarios.