Talk:List of benzodiazepines/Archive 1

Ketazolam
The 2 hour half life of ketazolam was a typing mistake in professor Ashton's Equivalence Table and professor heather ashton had her equivalence table corrected in print and online. I have updated this information in wikipedia to reflect the correction of this mistake. [Ashton CH Equivalent Table] I hope that this resolves the dispute.

Carpetman2007 1:01 am Saturday 15th April 2007 (UTC)
 * Isn't ketazolam metabolizeb pretty quickly to its active metabolites nordazepam and diazepam?--84.163.75.62 (talk) 11:39, 7 January 2008 (UTC)

I am not sure about how quickly it is metabolised into diazepam and then nordazepam. It is metabolised from ketazolam to demoxepam and then to diazepam and then to oxazepam, temazepam and nordazepam. Nordazepam has a half life of between 36-200 hours.--Literaturegeek (talk) 20:40, 6 May 2008 (UTC)

Midazolam
I believe the midazolam equivalency dose is wrong. In research I haven't been able to find much more than anecdotal comments that 15mg is about equivalent to 10mg Diazepam. Because it's more sedating though it appears to be stronger. Can anyone find a citation for this? It's left out of Ashton's Equivalence Table and most sites seem to mirror only that data. I'd love to update it but I don't want to change it without a source though. Apastsoliloquy (talk) 06:49, 13 August 2009 (UTC)apastsoliloquy

The best that I can find is this study on equivalency. Based on it it seems that the equivalence given in this wikipedia article is roughly accurate. I have added this ref to the article.-- Literature geek |  T@1k?  14:13, 13 August 2009 (UTC)

Bentazepam
This benzodiazepine is totally missing. It is sold under the moniker "Thiadipone" respectively "Tiadipona"... —Preceding unsigned comment added by 80.139.26.38 (talk) 08:20, 18 March 2010 (UTC)
 * Thanks for your comments. I am not sure if this benzodiazepine is actively marketed anywhere in the world? There is no equivalence information to other benzodiazepines. There are literally hundreds of benzos out there; what makes this benzo notable?-- Literature geek |  T@1k?  23:59, 18 March 2010 (UTC)
 * I think the fact that you could get it prescribed in Spanish speaking parts of the world should be worth enough mentioning it. The Russian one is in the list, too. The pharmaceutical producer/the brand is Abbott... —Preceding unsigned comment added by 80.139.68.189 (talk) 13:37, 24 March 2010 (UTC)
 * Ah ok, thank you for the information. Do you have any references for its dose equivalence in relation to another benzodiazepine drug?-- Literature geek  |  T@1k?  19:33, 24 March 2010 (UTC)
 * Ok, I found this source, a rough guess would say that 75 mg of bentazepam is equivalent to about 20-25 mg of diazepam. It is a very rough equivalency though because it is just one study showing prescribed doses in patients with liver disease. The source actually shows a lower equivalent dose for diazepam of 10 mg, but that is because diazepam levels double in people with liver disease due to its long half life, so dose is reduced in those with liver disease, so I think as bentazepam is short acting, if we are going to calculate an equivalence then comparing it to the other short acting benzos will get a more accurate picture. So 1 mg of alprazolam = 20 mg of diazepam, 2.5 mg of lorazepam = 25 mg of diazepam, 50 mg of oxazepam = 25 mg of diazepam; so 75 mg probably = between 20-25 mg of diazepam. See bolded text below copied from source and compare to available equivalencies in sources for this wikipedia article for the benzos other than bentazepam.

Prescribed daily dose (PDD) as percentage of the defined daily dose (DDD) of the main groups of medication in patients with liver cirrhosis. Data are given as weighted mean ± standard deviation. (1 DDD is equivalent to, respectively, 10 mg glibenclamide, 0.160 mg gliclazide, 10 mg glipizide, 0.375 mg chlorpropamide, 0.25 mg digoxin, 5 mg amlodipine, 30 mg nifedipine, 240 mg diltiazem, 20 mg nisoldipine, 240 mg verapamil, 50 mg captopril, 10 mg enalapril, 150 mg irbesartan, 25 mg ramipril, 15 mg fosinopril, 3 g acetaminophen, 400 mg tiapride, 576 mg chlormethiazole, 2.5 mg lorazepam, 10 mg diazepam, 1 mg alprazolam, 75 mg bentazepam, 20 mg clorazepate, 10 mg bromazepam, 50 mg oxazepam, 1 mg lormetazepam, 1 mg flunitrazepam).
 * This is bordering on original research though which makes me feel uneasy, but it seems the best available evidence for determining the equivalence; unless you have access to a prescribing formula for this drug? I am still not sure we should add it to the article. What are your thoughts?-- Literature geek |  T@1k?  20:44, 24 March 2010 (UTC)

Dr Heather Ashton
re - Dr Heather Ashton, & Citation(s) Required for Equivalency Table

With all due respect to Dr Ashton and her credentials - I'd feel more comfortable with information authored by someone with more recent credentials along with more recent research, broader studies, etc

For example, the equivalent dosing given for (the most commonly prescribed benzos) xanax, ativan, klonopin, and ambien are questionable and everywhere I've looked where Dr Ashton's table is published, a note / disclaimer is given that user / patient experiences will vary.

Again, I have utmost respect for Dr Ashton, but I feel her conclusions derived from her research are a bit dated.

On the flip side - I had a frustrating experience finding anyone else's work published or referred to that could be used to support my concerns for my "Talk" contribution. (so please, no flaming nor bashing) :-)

==

I agree with the above. The Equivalence Table seems to be based mainly on Dr. Ashton. Dr. Ashton's equivalences are different from most older & newer tables. In my personal experience, her equivalence for Clonazepam (.5mg = 10mg Diazepam) is too low; most authorities give 1.0mg = 10mg Diazepam, and this agrees with my experience. I use this as a key indicator of whose numbers I am looking at. Of course there can be major differences between individuals, depending on liver health, other meds, etc.: Your Mileage May Vary. Perhaps there should be two or three equivalent columns from major sources properly cited.D A Patriarche (talk) 01:30, 4 January 2014 (UTC)

Clonazepam
I am surprised that clonazepam 1.5 mg is listed as equivalent to lorazepam 1 mg. Most sources suggest that the equivalence is either clonazepam 0.25 mg or 0.5 mg to lorazepam 1 mg. — Preceding unsigned comment added by Wibennett (talk • contribs) 23:53, 6 November 2013 (UTC)
 * There was an anonymous IP editor that kept changing it. You can fix it if you like and add the page to your watch list to monitor for any changes..-- MrADHD  |  T@1k?  00:00, 7 November 2013 (UTC)

A few common(ish) diazepines missing?
I've been looking for as up-to-date and complete a list as possible for dose equivalences for (benzo)diazepines and related drugs and this seems a pretty good one, but Diclazepam and Flubromazepam at least seem to be missing (these are analogues, thienodiazepines I think). Not sure about Flubromazepam but for Diclazepam 1mg is supposed to be equivalent to 10mg Diazepam give-or-take. There are wikipedia articles on both, is there a reason they're not in the list? Also, etizolam and pyrazolam are in there despite also being analogues and not true benzodiazepines and I was wondering if it'd be better if the list was split into three (benzos, benzo-analogues, and then the z-drugs). I was going to go ahead and just add an entry for Diclazepam but I'm no expert on the subject so thought it best to reach a consensus first.

Cheers! — Preceding unsigned comment added by 95.150.75.96 (talk) 15:13, 5 June 2014 (UTC)

Removal of the "Power" of each drug.
The word "power" is misleading. It is essentially meaningless unless you ascribe some source or rate to which it refers to. It isn't used in any of the comparisons cited. The closest meaning is probably duration of action, but there is also onset of action and equivalency comparison. There should be a different column for duration of action and onset of action instead of power.Mbenzdabest (talk) 23:20, 27 June 2015 (UTC)

Power listing on many of these makes no sense and seems to be loosely based on opinion, there are several listings with exactly the same "equivalent dose" yet have different power levels listed. The Equivalent Dose column serves this exact same purpose with more accuracy and is easier to back up with sources. Simply removing the power notes would be to optimal thing to do to avoid reader confusion. LeviathanBaphomet (talk) 03:51, 3 July 2015 (UTC)

First, this page needs to be made semi-protected by an administrator; it changes more times than Kirstie Alley's weight. However, I do think the main reason the public accesses this page is precisely for the "equivalent dosage" part of the article. If not on the main table, it should be placed somewhere in this entry. The only "List of [blank] medications" article that futilely attempts to equate drugs in the same class in all of Wikipedia is this one. And since Xanax is the second most abused prescription drug in the United States, and along with alcohol and OxyContin account for half of ER visits, the motive is clear. But I digress. For the sake of quality and professionalism in wikijournalism, every single dose needs to be properly cited by a reputable source. This begins by removing references such as "wwww.drbob.com" and "www.benzos.org." For example, Medscape features its own benzodiazepine equivalency chart. Mescape is wholly owned by WebMd, a highly regarded website with its own peer-reviewed academic journal and accredited nationally by many organizations. A link to the full prescribing information from the manufacturer for each drug would also establish credibility. Additionally, instead of placing a fixed amount as a dose, perhaps a range would make more sense. Lastly, the pharmokinetics of substances in any given person's body vary widely in a population and there is no one-size-fits-all approach. The incident of the guy who took an Ambien and proceeded to murder his family, remove the skin from his face and body with a knife and was ultimately found in the middle of a forest completely unaware of what happened... speaks for itself. Mbenzdabest (talk) 05:46, 23 August 2015 (UTC)
 * The potency of every Benzo is the MAIN REASON why 90% of people consult this page. This is now just a list of benzos with their commercial names. Please put the potency column again.

--177.230.53.168 (talk) 08:03, 26 August 2015 (UTC)
 * The Medscape table is probably the most reliable source. Here's the link if someone wants to generate a new table based on it. Sizeofint (talk) 14:50, 26 August 2015 (UTC)
 * Dosing information is against WP:MEDMOS Sizeofint (talk) 02:01, 27 August 2015 (UTC)
 * Apparently MEDMOS currently allows this. Unless consensus changes, I revert to my previous statement. Sizeofint (talk) 02:09, 1 September 2015 (UTC)
 * The addition of a dosage equivalences column is allowed now per the recent MOS revision, but the references that were used before were completely inadequate since there were compounds with a dosage comparison entry that weren't cited by a reference. It'd be ok to add this column back in now if it's adequately cited though.  Seppi  333  (Insert 2¢) 21:45, 7 October 2015 (UTC)

Benzolist userpage.
I don't know if Meodipt is still very active, but I noticed an attempt to fill out some of the rarer benzoiazepines on a personal sub-page here: User:Meodipt/benzolist. Perhaps someone who is willing can incorporate some of it to this page? Nagelfar (talk) 21:08, 7 October 2015 (UTC)
 * IMO, adding the research compounds (the chems with names like "Ro16-0153") would be a bit excessive, but it'd be good to have the any/all of the others added here.  Seppi  333  (Insert 2¢) 21:50, 7 October 2015 (UTC)
 * Well, a bundled tab at the end, like on the "table of morphinan/non-morphinan" images at the opioid article for the more versed research compounds perhaps, where it isn't overt and taking up much space in the article. Nagelfar (talk) 01:38, 8 October 2015 (UTC)
 * May as well add it and fill in the blanks as needed then... Meodipt (talk) 09:48, 8 October 2015 (UTC)