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KEY WORDS: sedative, anxiety, tranquillizer, benzodiazepene, barbiturate, Zolpidem (Ambien), gamma aminobutyric acid (GABA) receptor, automatism, amnesia, disinhibition, hostility, rage
TARGET AUDIENCE: Behavioral scientists, forensic examiners, pharmacologists
PROGRAM LEVEL: Basic
DISCLOSURE: The authors have nothing to disclose.
PREREQUISITES: None
Addiction, dependence, withdrawal syndromes, memory disturbances, amnesia, disinhibited behavior, violence, impulsivity, automatistic and somnambulistic states, and cognitive and neuropsychological impairments result at least in part from activation of receptors in the brain for the neurotransmitter Gama Aminobutyric Acid (GABA)
This mechanism is responsible for many of the common, shared, and similar actions of various tranquillizing drugs used for relief of anxiety, for night-time sedation, as anticonvulsants, as a muscle-relaxant, and for surgical anesthetic purposes.These tranquillizing drugs of superficially very different chemical classes share this GABA mechanism, and they produce effects similar to beverage alcohol, ethanol.
These drug effects, alone and in interaction with other drugs, combine with idiosyncratic neurobiological vulnerabilities to bring the user's behavior to forensic notice in a wide variety of criminal and civil cases.
The recent death of singer Michael Jackson has focused popular attention on the drug propofol (Diprivan) that is relatively unknown outside of hospital anesthesiology. This drug shares many pharmacological similarities with a number of tranquilizing drugs that are widespread and common in use and abuse and form the bulk of the pharmaceutical money train. The relative availability and prevalence of illicit (nonprescribed) or non-medical use of tranquilizing drugs has paralleled their emergence into medical markets and constitutes a major problem in drug abuse. This review addresses a common mechanism, and certain common effects, shared by the majority of currently-available tranquilizing drugs of widely different chemical families' action at the brain's GABAA receptors (described more fully below). Notwithstanding these mechanistic similarities or commonalities, however, different members of the class also exert actions at non-GABAA sites and mechanisms in addition.
The purpose of this article is to provide an understanding and appreciation of the shared and common GABA4 mechanisms and effects that tranquilizing drugs mediate on brain, mind, and behavior in circumstances of forensic relevance. Although the incidence rate of disabling psychotoxic effects caused by GABAA stimulation is relatively rare in the general population of therapeutically-prescribed users, it is higher in the drug abuser population, and in both populations of...