A review of the literature of drug interactions of the antianxiety agents yields little of clinical significance. Recorded drug interactions of this group involve primarily meprobamate, chlordiazepoxide, and diazepam. The only interaction of note with meprobamate is the development of tolerance partially as a result of microsomal enzyme induction by meprobamate, chronic alcohol ingestion, and possibly some other agents. Of the benzodiazepine interactions, the one of most serious note is the incidence of respiratory depression and/or hypotension which occurs when diazepam is given intravenously for convulsions after prior parenteral administration of a barbiturate. The benzodiazepine derivatives may inhibit diphenylhydantoin metabolism. Hence, patients on diphenylhydantoin therapy should be closely monitored when the benzodiazepine anti-anxiety agents are introduced to or deleted from the therapeutic regimen.
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