FROM BENZODIAZEPINE PRESCRIPTION TO DEPENDENDENCE: LEARNING PROCESSES INVOLVED.

EMILCE ARTUR DE LA VILLARMOIS; FLORENCIA CONSTANTIN; MARIELA F. PÉREZ; GARGIULO PASCUAL ANGEL

Psychiatry and Neuroscience Update Vol III

Springer

Año: 2019;

Benzodiazepines (BZD) are usually prescribed for anxiety and sleep disorders in long-term treatments that may cause drug dependence, because in many cases are used inappropriately. The abuse, insufficiency or inadequacy in drug use harms the users and contributes to increasing expenses of public resources. It has been described that a context-dependent associative learning process underlies BZD tolerance and dependence. In fact long-lasting neuroadaptations within the limbic system occurred after repeated drug exposure, such as alterations in synaptic plasticity at glutamate synapses in brain structures related to memory formation such as the hippocampus and in the reward system, involving the ventral tegmental area, nucleus accumbens and frontal cortex. Furthermore, BDZ engage pharmacological and cellular mechanisms in the mesolimbic dopaminergic system, that are physiologically similar to those which have previously been identified for other drugs of abuse. In this chapter we discussed some of the molecular and functional changes within the limbic and reward systems induced by repeated BZD administration and the pharmacological or methodological strategies used or proposed to prevent BZD tolerance and dependence in both, animal models and humans.