Author: James Anderson
Benzodiazepines: What They Are, Uses, Side Effects & Risks
On important factor with respect to long term use is whether tolerance is a major complicating factor. The literature suggests heavy use of BZDs in many countries, although the pattern varies greatly 29. Because different methods were used in the various usage studies, the data are too heterogeneous to sustain a meta-analysis. The prevalence figures from one UK study show that anxiolytics were used in the 15–44 year age group by 0.4% of the population, in the 45–64 year age group by 0.8% and in the over 65-year-olds by 1.9%. BZD anxiolytic usage has stayed largely the same over the past two decades 30.Use of hypnotic BZDs has reduced sharply but has been largely replaced by the Z-drug hypnotics. About two-thirds of patients stop completely with a slow tapering schedule.
Withdrawal and dependence
In the U.S., about 6 million adults, or 2.7% of the population is affected. A person with panic disorder has panic attacks which are repeated episodes of intense fear which may be expected or unexpected. These symptoms may be accompanied by physical symptoms that are similar to the body’s normal response to danger, often called the “fight or flight” phenomenon. Panic attacks may accompany other mood disorders such as depression, anxiety or substance abuse conditions.
- The use of flumazenil in benzodiazepine overdose is controversial and the risks may outweigh any possible benefit.
- A Boxed Warning, the FDA’s most stringent safety warning, exists on all benzodiazepine product information.
- All benzodiazepines are listed as DEA schedule IV controlled substances.
- Many traditional benzodiazepines are broken down in the liver and when combined with drugs that block this action, blood levels can rise, leading to side effects.
- Benzodiazepines should be used with extreme caution in the elderly due to the risk for excessive sedation, confusion, falls and fractures.
Others, such as cognitive decline, can persist for several months, according to a 2005 review published in the Journal of Clinical Psychiatry. Cognitive abilities that can be affected by benzos include the ability to identify visual relationships between objects, the amount of time it takes to process information, and verbal learning skills. Most people feel side effects of fast-acting benzos between 30 and 60 minutes after taking the drugs. Misusing the drugs by snorting them can decrease the length of time it takes to feel desired effects and side effects. Benzos aren’t recommended for long-term use because they become less effective over time. As the body continues to adapt to the presence of the benzo, it requires higher doses to feel a therapeutic effect.
What conditions do benzodiazepines treat?
If you feel that the medicine is not working as well, do not use more than your prescribed dose. Ask your healthcare professional how you should dispose of any medicine you do not use. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Appropriate studies have not been performed on the relationship of age to the effects of lorazepam tablets and oral liquid in children younger than 12 years of age and extended-release capsules in children. All benzodiazepines work in a similar way but there are differences in the way individual benzodiazepines act on different GABA-A receptor sub-types. In addition, some benzodiazepines are more potent than others or work for a longer length of time.
Choice of treatment
Benzodiazepines are potentially addictive and the risk of becoming emotionally and physically dependent on them increases the more you take. This is when the same dose no longer gives the same effect, and a dosage increase is needed to ease symptoms again. Such studies are the exception, with usually only two out of the three time phases. The above meta-analysis of neuropsychological tests revealed improvement in several cognitive functions, up to 6 months after BZD discontinuation, but ex-users of BZDs still performed poorly 6.
Benzodiazepines should be avoided in patients with a history of drug abuse. A Boxed Warning, the FDA’s most stringent safety warning, exists on all benzodiazepine product information. When benzodiazepines are combined with other sedatives, opiates or alcohol, the risk of serious side effects such as profound sedation, respiratory depression, coma, and death may occur.
Panic disorders
Other uses include the inducement of calm before surgery or a medical procedure and the treatment of muscle spasms, irritable bowel syndrome (IBS), and abnormal sleep patterns. Long-term use of benzodiazepines can lead to adverse behavioral symptoms and drug dependence. When a healthcare provider uses a drug approved by the Food and Drug Administration (FDA) for an unapproved use, that use is considered off-label. It is essential not to use benzodiazepines with opioids or alcohol, as this can lead to life threatening effects. Before starting treatment with benzodiazepines, a person must tell their doctor about every other medication that they are using. Benzodiazepines may be used at the beginning of therapy to lessen symptoms while the antidepressants take effect, which may take 4 to 6 weeks.
It usually quickly subsides due to tolerance to the subjective effects. At higher doses, unsteadiness, slurring of speech and disorientation indicate over-sedation particularly when the BZD is combined with alcohol. Cognitive and psychomotor impairment can be detected even at ostensibly therapeutic doses. This can ensue during the whole day when the BZD is prescribed several times during the day as an anxiolytic, or a long acting BZD the night before as a hypnotic. It will be confined to the morning following a short acting sleeping pill.
This form of epilepsy may involve seizures of multiple types, mental impairment, and a particular brain wave pattern. Clobazam (Onfi) is used as an add-on (adjunct) benzodiazepine anticonvulsive treatment with other seizures medications in the treatment of Lennox-Gastaut syndrome. Benzodiazepines such as diazepam may also be used short-term as a muscle relaxant. These are generally used to relieve acute painful skeletal muscle spasms, such as what might occur with acute lower back muscle spasm. They are added as an adjunct to rest, physical therapy and / or heat and ice. Overdosing on benzos alone is rarely deadly, but it only takes a small amount of a benzo to interact with another drug and cause serious health issues.