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Using anxiolytics in epilepsy: neurobiological, neuropharmacological and clinical aspects Volume 18, issue 3, September 2016

TEST YOURSELF

 

(1) What is the difference between 1,4 and 1,5 BZDs?

A. They have a different half-life and metabolism

B. 1,5 BZDs do not bind the GABA-A receptor complex

C.1,5 BZDs do not have a significant hypnotic effect

D. 1,4 BZDs do not have muscle relaxant properties

 

(2) Which of the following statements is correct regarding the use of anxiolytics in children?

A. Short-acting BZDs represent first-line treatment in children

B. Short-acting BZDs should be avoided or carefully used in children

C. 1,4 BZDs are contraindicated in children

D. 1,5 BZDs are contraindicated in children

 

(3) What can be considered as first-line treatment for patients with epilepsy and generalised anxiety disorder?

A. 1,5 BZDs

B. Imidazo-BZDs

C. Levetiracetam

D. Pregabalin

 

 

 

 

 

 

 

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Answers

(1) C. While all 1,4 BZDs have more or less a significant hypnotic effect, 1,5 BZDs lack such an effect, accounting for why clobazam has a different impact on cognitive functions, compared to diazepam.


(2) B. Children may present paradoxical reactions to short-acting BZDs. This is a well-known phenomenon, for example, with midazolam when used to induce mild sedation for elective surgical/invasive procedures. Adult patients with intellectual disabilities are affected similarly to children and may develop paradoxical agitation and aggressive behaviour with short-acting BZDs. For this reason, this specific subcategory should be avoided or carefully used in these patients.


(3) D. For generalized anxiety disorder, pregabalin can be considered as first-line treatment for acute and long-term maintenance treatment, as it is licensed, although not everywhere, for both conditions.

 

 

 

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