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Benzodiazepine

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"Bennies"

The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsive, amnestic and muscle relaxant properties. They are believed to act on the GABA receptor GABAA, the activation of which dampens higher neuronal activity. They began to be widely prescribed for stress-related ailments in the 1960s and 1970s.

Benzodiazepines are often used for short-term relief of severe, disabling anxiety because their prolonged use can lead to tolerance and dependency.

These drugs are preferred to the use of barbiturates because they have a lower abuse potential and relatively lower adverse reactions and interactions. However, drowsiness, ataxia, confusion, vertigo, impaired judgement, and a number of other effects are still common.

Duration of Action

Benzodiazepines are commonly divided into three groups. Short-acting compounds act for less than six hours and have few residual effects, but rebound insomnia may occur and they might cause wake-time anxiety. Intermediate-acting compounds have an effect for 6-10 hours, may have mild residual effects but rebound insomnia is not common. Long-acting compounds have strong sedative effects that persist. Accumulation may occur.

Immediate dangers

Benzodiazepines may impair the ability to drive vehicles and to operate machinery. The impairment is worsened by consumption of alcohol, because both drugs act similarly on the central nervous system. The effects of long-acting benzodiazepines can also linger over to the following day.

Abuse and dependence

Benzodiazepines induce physical dependence and are potentially addictive. An abrupt discontinuation of benzodiazepine input may result in convulsions, confusion, psychosis, or effects similar to delirium tremens (DTs).

Hence, every person on long-term or high dosage of any benzodiazepine should be carefully weaned off the drug.

Onset of the withdrawal syndrome might be delayed, and it might be delayed longer than the barbiturate withdrawal syndrome. Even when withdrawal from short-acting benzodiazepines often presents early.

The benzodiazepine withdrawal syndrome is characterized by:

  • insomnia
  • anxiety
  • tremor
  • perspiration
  • loss of appetite
  • delusions

It should be noted that some of the aforementioned withdrawal symptoms are identical to the symptoms for which the medication was originally prescribed. Benzodiazepines can help existing conditions, whlie benzodiazepine dependency can cause them.

As it happens, benzodiazepines are the largest group of recreationally used drugs as well. [1]

Examples of benzodiazepines

These drugs are listed in order of the shortest acting to the longest acting (by the approximate half-life of the drug), however this time may greatly vary between persons.


These drugs are not benzodiazepines, but have similar effects:

Notes:

In the US, Versed is mostly only used as an injection for sedation before surgical procedures

flunitrazepam ("Rohypnol") and bromazepam ("Lexotan") are Schedule I narcotic agents, and not commercially available in the united states.