OBJECTIVES: To report the prevalence and factors associated with the use of benzodiazepines in the general population and those with a mental health condition in the metropolitan area of São Paulo, Brazil. METHODS: 5,037 individuals from the Sao Paulo Megacity Mental Health Survey data were interviewed using the Composite International Diagnostic Interview, designed to generate DSM-IV diagnoses. Additionally, participants were asked if they had taken any medication in the previous 12 months for the treatment of any mental health condition. RESULTS: The prevalence of benzodiazepine use ranged from 3.6% in the general population to 7.8% among subjects with a mental health condition. Benzodiazepine use was more prevalent in subjects that had been diagnosed with a mood disorder as opposed to an anxiety disorder (14.7% vs. 8.1%, respectively). Subjects that had been diagnosed with a panic disorder (33.7%) or bipolar I/II (23.3%) reported the highest use. Individuals aged ≥50 years (11.1%), those with two or more disorders (11.2%), those with moderate or severe disorders (10%), and those that used psychiatric services (29.8%) also reported higher use. CONCLUSION: These findings give an overview of the use of benzodiazepines in the general population, which will be useful in the public health domain. Benzodiazepine use was higher in those with a mental health condition, with people that had a mood disorder being the most vulnerable. Furthermore, females and the elderly had high benzodiazepine use, so careful management in these groups is required.

Os ataques de pânico são representados por um período distinto no qual há o início súbito de intensa apreensão, temor ou terror, freqüentemente associados com sentimentos de catástrofe iminente, diagnosticado em aproximadamente 10% da população. O Transtorno de Pânico é um transtorno de ansiedade que se caracteriza pela recorrência de ataques de pânico: crises súbitas de mal-estar e sensação de perigo ou morte iminente, acompanhadas de diversos sintomas físicos e cognitivos. Os indivíduos com Transtorno de Pânico apresentam, caracteristicamente, preocupações acerca das implicações ou conseqüências dos ataques de pânico. É uma condição clínica complexa que envolve diferentes modalidades ou conglomerados de sintomas. Assim, o foco nas sensações físicas erroneamente interpretadas no transtorno de pânico e na hipocondria centraliza-se basicamente nas manifestações autonômicas, como taquicardia e dispnéia. Há poucos estudos sobre atividade física e transtorno de pânico. O principal objetivo do estudo visa identificar com diferentes descrições se há uma população "nuclear" com sintomas predominantemente respiratórios apresentando esquiva de atividade física e a influência do exercício nesta população.

Panic attacks are represented by distinct periods in which there is a sudden beginning of internal apprehension, fear or terror, frequently associated with feelings of imminent catastrophe, diagnosed in approximately 10% of the population. The panic disorder is an anxiety crisis that is characterized by the recurrence of panic attacks: sudden crises of uneasiness and sensation of danger or imminent death, followed by diverse physical and cognitive symptoms. Individuals with panic disorder are characteristically concerned about panic attacks implications or consequences. It is a complex clinical condition that involves different modalities or myriad of symptoms. Thus, the focus on the physical sensations misinterpreted in panic disorder and hypochondria, is basically centered in autonomic manifestations, such as tachycardia and dyspnea. There are scarce studies on physical activity and panic disorder. The main purpose of the study is to identify with different descriptions whether there is a 'main' population with symptoms predominantly respiratory presenting avoidance of physical activity and exercise influence on this population.

Os autores procuram abordar, através de revisão da literatura recente, os principais aspectos a respeito dos benzodiazepínicos (BDZ), uma das drogas largamente utilizadas em todo o mundo como ansiolíticos e hipnóticos. Para isso, sáo apresentados: breve histórico sobre o surgimento das drogas hipnótico-sedativas e ansiolíticas, e como evoluiu seu consumo (e abuso) ao longo dos últimos anos; os principais conceitos aceitos a respeito dos mecanismos de ação dos BDZ; o desenvolvimento de tolerância aos efeitos dos RDZ, abordando inclusive sua tolerância diferencial; por fim, alguns aspectos sobre a sfndrome de abstinência que se segue à retirada abrupta dos BDZ, enfocando a questão da dependência.

The authors review recent studies on benzodiazepine, the most largely used drug for insomnia and anxiety. In this paper are summarized: the development, patterns of use and abuse, mechanism of action, development of differential tolerance to its many effects, and the phenomena of withdrawal and dependence on the benzodiazepines.