Uncovering forgotten trials, the podcast explores the potential effectiveness of benzodiazepines in treating depression. It discusses the transition from barbiturates to benzos for sleep disorders, highlighting their GABAergic mechanisms and safety profiles.
Benzodiazepines, like alprazolam, show potential as antidepressants, especially for mild cases of depression.
Using benzodiazepines as adjunctive therapy with antidepressants can speed up the antidepressant effect, but long-term outcomes may vary.
Deep dives
The History of GABAergic Medications in Depression
This podcast explores the historical use and efficacy of GABAergic medications, such as benzodiazepines, in treating depression. It discusses how older GABAergic drugs, like barbiturates, were replaced by benzodiazepines and later by the Z hypnotics. The podcast highlights that these medications are GABAergic and have differences in safety but not efficacy. It also addresses the shifting definition of depression and the role of GABAergic medications in its treatment. The episode delves into studies that suggest benzodiazepines, particularly alprazolam, can have direct antidepressant effects, though they are more effective for mild cases of depression and less so for melancholic depression. However, the podcast emphasizes the lack of long-term studies on benzodiazepines in depression and discusses concerns about dependence, tolerance, withdrawal, and the impairment of cognitive and emotional functions associated with their use.
Alprazolam's Antidepressant Potential
This segment focuses on the antidepressant potential of alprazolam, a high-potency triazole benzodiazepine. It highlights that alprazolam has been extensively studied in depression and has shown efficacy comparable to antidepressants, not only for anxiety but also for core symptoms of depression. The podcast mentions that alprazolam is not FDA-approved for depression but is considered effective for anxiety due to depression. It discusses the evidence from controlled trials and Cochrane reviews supporting alprazolam's antidepressant effects. However, the segment also raises concerns about its abuse potential, overdose risks when combined with opioids, the lack of long-term studies, and the cognitive and emotional impairments associated with benzodiazepine use.
Balancing Benefits and Risks of Benzodiazepines
This part of the podcast explores the cautious approach towards using benzodiazepines, particularly alprazolam, in depression treatment. It mentions that while benzodiazepines can be effective, they come with risks such as dependence, tolerance, withdrawal, and potential adverse effects on cognition and emotional recognition. The episode discusses the use of benzodiazepines as adjunctive therapy alongside antidepressants, noting that this strategy can speed up the antidepressant effect but may not make a long-term difference. It highlights the importance of preparing patients for benzodiazepine tapering and the challenges of discontinuing the medication due to its rewarding effects. The segment also emphasizes the need for individualized treatment decisions, considering factors such as comorbid conditions, abuse potential, overdose risks, and patient tolerance.
The release of the fast-acting antidepressant Auvelity got us thinking about an older strategy to speed up antidepressants, benzodiazepines. So we're bringing you this Thursday throwback, do benzodiazepines treat depression? Benzos and sleep meds rarely earn a mention in textbooks on depression these days, but that has not always been the case.
Today, in part one of a two-part series, we'll open up a forgotten repository of psychiatric research, where a stack of about 50 controlled trials has been archived away, suggesting that the GABAergic benzos might actually treat depression.
Chris Aiken, MD, and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Remember Everything You Learn from Podcasts
Save insights instantly, chat with episodes, and build lasting knowledge - all powered by AI.
