Phenazepam

Phenazepam is evaluated for the following indications with varying evidence strength: Acute anxiety, short-term treatment (evidence tier B), Generalized anxiety disorder (evidence tier D), Behavioral disturbance in dementia (evidence tier F). See the full indication matrix with dosing and citations above on this page.

Common side effects of Phenazepam (≥ 1 in 100): Sedation, drowsiness, fatigue, Ataxia, Anterograde amnesia, Reduced attention, slowed reactions, Muscle weakness. See the Safety section for uncommon and serious reactions.

FDA category D. Not classified under the FDA system as it is not US-registered. Per Russian local recommendations, contraindicated in pregnancy due to teratogenic risk (cleft palate) and third-trimester floppy infant syndrome and neonatal withdrawal.

Contraindicated during breastfeeding. Active metabolites with long half-life accumulate in the infant.

Phenazepam is contraindicated in: Hypersensitivity to benzodiazepines; Acute angle-closure glaucoma; Myasthenia gravis; Severe respiratory insufficiency; Sleep apnea syndrome. Full list in the Safety section.

one of the most addictive benzodiazepines with severe withdrawal. Not in international guidelines, not approved by FDA or EMA.

dependence develops within 2–3 weeks. First-line drugs for anxiety are SSRIs and CBT.

combination sharply increases respiratory depression, aspiration, and death risk. Fatalities have been reported with phenazepam plus alcohol or opioids.