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Half Life and Onset Table

The LOT benzodiazpines (**L**orazepam, **O**xazepam, and **T**amazepam are metabolized via glucuronidation (Phase II metabolism), which is less dependent on global liver function. Thus, these benzodiazepines can be used in individuals with severe liver impairment.

Benzodiazepine	Onset	Half-life	Use Case
‣ IM	Rapid (15 min)	2-3 hours (shortest half life)	Sedation, Seizure,
‣	Rapid	12 hours (short)	Agitation, Seizure, prn specific phobia, liver disease
‣	Intermediate	12 hours (short)	Panic Disorder, Essential Tremor
‣	Rapid	12-48 hours (Long)	Panic Disorder, Essential Tremor
‣	Rapid	24-100 hours (Long)	Alcohol Withdrawal

*NOTE: citalopram and escitalopram are SSRI

More Info:

Introduction to Benzodiazepines

Clinical Pearl

Start anti-depressant after a short dose of benzo
- Benzo works faster than SSRI -> Give some positive association with ant-depressant -> ensure adherence
- Once anti-depressant starts working, taper off the benzo
NOT GOOD at ABORTING a panic attack
- Tablet: by the time it’s absorbed, works in 45 min
  - Panic attack: peak within 1 min
- Sublingual: works in 15-20 min