Bromazepam
Bromazepam is an intermediate-acting benzodiazepine licensed for short-term anxiety in many European and other countries. It provides reliable anxiolysis but shares the class dependence, tolerance, and withdrawal liability, with seizure risk on abrupt cessation.
01 Overview
Bromazepam enhances GABA-A signalling to produce anxiolytic and sedative effects, and is used for short-term management of anxiety and tension. It is widely prescribed outside the United States, where it is not FDA-approved.
With regular use, tolerance and physical dependence develop, and abrupt discontinuation can cause rebound anxiety, insomnia, and seizures. Cognitive impairment and additive respiratory depression with opioids or alcohol are shared class hazards.
02 Mechanism
Positive allosteric modulator of the GABA-A receptor; enhances GABAergic inhibition producing anxiolysis and sedation.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Light | 1.5–3 mg | Oral | Lower dose for mild anxiety or elderly. |
| Common | 3–6 mg | Oral | Typical anxiolytic per-dose range. |
| Therapeutic (daily) | 6–18 mg/day | Oral | Divided daily total; higher hospital ranges under supervision. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| AnxiolysisReliable reduction of anxiety and tension. | Clinical | ||
| SedationDose-dependent drowsiness and calm. | Clinical | ||
| Muscle relaxationMild reduction in muscle tension associated with anxiety. | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Dependence and withdrawalTolerance and dependence; abrupt cessation can cause rebound anxiety, insomnia and seizures. | Severe | Common with regular use | Clinical | |
| Respiratory depressionAdditive respiratory and CNS depression with opioids or alcohol. | Life-threatening | Uncommon alone, higher with CNS depressants | Clinical | |
| Cognitive impairment and amnesiaDrowsiness, psychomotor slowing and memory impairment. | Moderate | Common | Clinical |