Talk:Benzodiazepine

broken chart

im not sure if its my screen or display but the table at the beginning is "broken", dont want to fix it because im not sure if its my screen only. DANIELTHEDON (talk) 16:21, 26 November 2018 (UTC)

Benzo[e][1,4]diazepine

Why is it benzo[e][1,4]diazepine and not benzo[f][1,4]diazepine? As far as I understand the IUPAC nomeclature (https://www.acdlabs.com/iupac/nomenclature/93/r93_229.htm) it should be named benzo[f][1,4]diazepine. --Esmu Igors (talk) 03:27, 15 September 2019 (UTC)

Legal Status

I am proposing that much of the "regulatory" clutter found in the legal stats section be moved elsewhere. While drugs may have lots of regulations surrounding their use, legal status is a horse of a different colour and this should be reflected in its own relevant section. A drug is either legal to use or it is not; whether its a "target of interest amongst seniors" for example is irrelevant. Daystrom (talk) 05:49, 6 December 2022 (UTC)

Wildly inaccurate citations

This article suffers from some wholly inaccurate or wildly hyperbolic citations, which I will attempt to clean up after first providing a few examples.

1. In the subsection about tolerance, the following claim is made: "Tolerance to anti-anxiety effects develops more slowly with little evidence of continued effectiveness beyond four to six months of continued use." This claim is backed up with [1], which mentions anxiolytic tolerance as follows: "Tolerance to the anxiolytic effects of benzodiazepines develops more slowly, over a few months, and clinical  observations show that long-term use does little to con- trol, and may even aggravate, anxiety [13]. There is also evidence of dosage escalation in anxiolytic users. In one clinical study over 25% of the patients were taking two benzodiazepines, the second having been added to the prescription when the first ceased to be effective [13]." You will notice both of these claims reference the same citation, which is another publication of the same author, H Ashton, and can be found here. This citation is not a review of any kind, not a randomized controlled trial examining the long term efficacy of benzodiazpines, it is simply an observational study of 50 patients referred to a specialized unit to discontinue their benzodiazepine as they wished to do so. This is frankly, very far off the standard of evidence required to make the claim "long term use does little to control [anxiety]". The only evidence here is that a subset of patients, of unknown size (but at least 50 people worldwide) will wish to discontinue their benzodiazepine and may not have found it effective long term.
2. Just after the above sentence, the following is found: "However, controversy exists as to tolerance to the anxiolytic effects with some evidence that benzodiazepines retain efficacy and opposing evidence from a systematic review of the literature that tolerance frequently occurs", however, to my eye, neither of the references back up the assertion that tolerance "frequently" occurs. In fact, reviews refute this claim (which I will add to this page).
3. Next, the same citation used in claim (1) is re-used for the following claim: "and some evidence that anxiety may worsen with long-term use." -- which is unscientific on it's face. Stating that anxiety "may" worsen with long term use is a statement that could be made about any intervention for anxiety of any kind.
4. The claim "A major disadvantage of benzodiazepines is that tolerance to therapeutic effects develops relatively quickly while many adverse effects persist. Tolerance develops to hypnotic and myorelaxant effects within days to weeks, and to anticonvulsant and anxiolytic effects within weeks to months." is backed up by a citation which quite simply does not state that anxiolytic tolerance develops within weeks to months, mentioning only: "but there are conflicting reports about the development of tolerance to the anxiolytic and memory effects (Coren- stein et al., 1994)."

I want to be clear that I have no issue with detailing the problems with benzodiazepines, but Wikipedia is supposed to be a trusted source and this means citations should say what they are claimed to have said. I was disappointed to find so many citations within this page that simply do not back up the claims on the page itself. I will work to try to fix this, while retaining the included citations. Instead of deleting them, I will, where applicable, retain them and reword the claims on the Wikipedia page so they align with the citation. However, for the cited study of 50 patients reporting for BZD withdrawal, I am not convinced this belongs anywhere near this article. It's not randomized, controlled, or representative in any way -- it is the definition of selection bias.

Open for discussion Statisticizer (talk) 23:11, 4 February 2025 (UTC)