[Why Benzodiazepines Are Still in Wide Use?].

[Why benzodiazepines are still in wide use?].

Acta Med Croatica. 2012 May; 66(2): 137-40
Vlastelica M, Jelaska M

The advent of benzodiazepines in the 1960s provided their wide use in neurology and psychiatry. They proved to be myorelaxant and anticonvulsive therapy in neurology; their anxiolytic and hypnotic properties have made them the treatment of choice for insomnia and anxiety problems; they have also been used in alcohol withdrawal and in anesthesia, and for a wide range of treatments in other clinical branches. However, reports giving rise to a prescription controversy including abuse, harmful effects, intoxication and dependence toward addiction appeared soon. On the other hand, the revolutionary appearance of selective serotonin reuptake inhibitors (SSRIs) overshadowed benzodiazepines. According to recommendations of many scientific and professional institutions, the use of benzodiazepines has been gradually excluded or reduced or limited to short-term use. However, clinical experience showed that benzodiazepines are frequently used for long-term treatment, and there are many reasons for this, e.g., prescribing tradition, patient preference, difficulties associated with benzodiazepine withdrawal (even in patients taking low doses) because they have a rapid clinical onset of action, and good efficacy with few initial adverse effects. Moreover, SSRIs as alternative drugs are associated with incomplete therapeutic response and more uncomfortable adverse effects. Some authors therefore point out that the rationale for the shift from benzodiazepines to SSRIs is inappropriate. HubMed – addiction

Reward and attentional control in visual search.

Nebr Symp Motiv. 2012; 59: 91-116
Yantis S, Anderson BA, Wampler EK, Laurent PA

It has long been known that the control of attention in visual search depends both on voluntary, top-down deployment according to context-specific goals, and on involuntary, stimulus-driven capture based on the physical conspicuity of perceptual objects. Recent evidence suggests that pairing target stimuli with reward can modulate the voluntary deployment of attention, but there is little evidence that reward modulates the involuntary deployment of attention to task-irrelevant distractors. We report several experiments that investigate the role of reward learning on attentional control. Each experiment involved a training phase and a test phase. In the training phase, different colors were associated with different amounts of monetary reward. In the test phase, color was not task-relevant and participants searched for a shape singleton; in most experiments no reward was delivered in the test phase. We first show that attentional capture by physically salient distractors is magnified by a previous association with reward. In subsequent experiments we demonstrate that physically inconspicuous stimuli previously associated with reward capture attention persistently during extinction–even several days after training. Furthermore, vulnerability to attentional capture by high-value stimuli is negatively correlated across individuals with working memory capacity and positively correlated with trait impulsivity. An analysis of intertrial effects reveals that value-driven attentional capture is spatially specific. Finally, when reward is delivered at test contingent on the task-relevant shape feature, recent reward history modulates value-driven attentional capture by the irrelevant color feature. The influence of learned value on attention may provide a useful model of clinical syndromes characterized by similar failures of cognitive control, including addiction, attention-deficit/hyperactivity disorder, and obesity. HubMed – addiction