Benzodiazepines, pronounced as , informally known as minor tranquilizers, belongs to a class of drugs known as central nervous system or CNS suppressant which is used in psychiatry, neurology and a few other branches of medicine This type of medicine has a nick name ‘benzos’ which slows down the signal transmission to and from the body to the brain thereby resulting in dawdling response in emotional, mental and physical activities. There are at least fifteen types of benzodiazepines available in the US market and twenty more in the other countries for the treatment of many physical as well as psychological woes. This effect of benzodiazepines used therapeutically for inducing sleep, producing sedation, relieving anxiety and panic, muscles spasm and help in seizure etc. Among all the drugs into the CNS suppressant class, benzodiazepines are the most prescribed drugs in the United States of America . Benzodiazepines have high sedative potential owing to which abusive usage of these drugs is in practice mainly with other sedative substances like alcohol and opiates like cannabis and heroin. This class of medicine is controlled in Schedule V Control Substance Abuse Act.
History of Benzodiazepines
The first benzodiazepine was introduced by Hoffman in 1957 long after its discovery by Leo Sternback during 1930s. The brand name for the medicine was Librium and it was for the treatment of anxiety disorder. The abuse of benzodiazepine was not a matter of concern till 1980s when it became a popularly prescribed drug. In 1999 near about 100 million prescriptions were prescribed for Benzodiazepines.
Benzodiazepines Use
The usages of benzodiazepines are mainly associated with problems of anxiety disorder, panic disorder and insomnia which are closely related to personal and social problems like grief, relationship difficulties, sexual assault, work related stress, domestic violence, and difficulty coping with babies or children difficulties with school, work, alcohol dependency or living with a person with alcohol or drug dependency migration. There are also physical conditions in which benzodiazepines are prescribed, these conditions are muscular pain or spasm gastro-intestinal symptoms, any chronic pain such as arthritis, injuries or stress following a car accident, headaches, high blood pressure, menopausal and menstrual problems, skin conditions, dementia. Some therapeutic uses are mentioned below:
Therapies Clinical Use
| Therapies | Clinical Use | ||
| Anxiolytic (relief of anxiety) | –> | Anxiety and panic disorders, phobias | |
| Hypnotic (promotion of sleep) | –> | Insomnia | |
| Myorelaxant (muscle relaxation) | –> | Muscle spasms, spastic disorders | |
| Anticonvulsant (stop fits, convulsions) | –> | Fits due to drug poisoning, a few forms of epilepsy | |
| Amnesia (impair short-term memory) | –> | Premedication for operations, sedation for minor Surgical procedures | |
| Other clinical uses for receiving combined effects:Alcohol detoxificationAcute psychosis with hyper-excitability and aggressiveness | |||
Benzodiazepines Psychological Effects
The psychological effects of benzodiazepines can be divided into four categories:
| Subjective: Reduces anxiety and induces sleep, relaxation and inertia.Behavioral: Hostility and depression, sexual improprieties, the patient may break down into uncontrollable weeping.Psychomotor: Brain functions related to speed and accuracy is affected in short term use; however, the effects depend on dose and different drugs.Cognitive: Disrupts the consolidation process in verbal memory and may experience episodes of global amnesia particularly with high dose or with alcohol. |
Toxic Effects
The use of benzodiazepines with other drugs or alcohol may have fatal results as a result of central nervous system depression. The overdose of this type of medicine has very rare death occurrences though.
Benzodiazepines Abuse
Abusive effects of benzodiazepines are associated with the recreational use of the drugs. Diazepam, alprazolam, lorazepam, temazepam, triazolam, flunitrazepam and others are used for recreational use in many countries to increase the effects of illicit drugs, like opiates, and also to lessen the withdrawal symptoms of opiates, amphetamines, cocaine, barbiturates and alcohol.
Physical Side-Effects
| VertigoDizzinessDysarthriaAtaxiaIncoordination may lead to falls | RashWeight gainProblem in sexual functionsMenstrual irregularitiesBlood dyscrasias |
Benzodiazepines Dependence
Benzodiazepines are habit-forming drug and the psychological and physical dependence may develop within more than three months of continuous use or if taken in high doses. Benzodiazepines are prescribed for short term use; three months maximum so that the patient does not become dependent on the medication.
Benzodiazepines Withdrawal
While deciding to stop taking the drugs, the patient should be ready to handle the withdrawal symptoms which may vary from person to person. The withdrawal symptoms include headaches, sweating, confusion, nervousness, tension, anxiety and panic attacks, dizziness, heightening of the senses of sight, touch, hearing, smell and taste, poor appetite, nausea, vomiting and stomach pains, inability to sleep properly, depression, feelings of isolation and unreality, delirium and paranoia. Some people may experience withdrawals for months, some may not experience at all. But, all need to remember that the withdrawals will wither away slowly.
To manage withdrawal effects, one should gradually reduce the dosage as per doctor’s advice.
Benzodiazepines Crisis Management
| In case of overdose of benzodiazepines, please take immediate professional help.Never delay in case of overdose, call the ambulance and remember that ambulance officers are not obliged to involve the police.Find someone who knows mouth-to-mouth resuscitation or cardiopulmonary resuscitation (CPR) to manage the condition till the ambulance arrives.Loosen the tie or any tight clothing; ensure that the patient is able to breathe properly.If the patient is unconscious, remember to turn him on his back, in the recovery position so that the air way is not blocked.Provide all information regarding how many tablets and when they were taken and other physical condition of the concerned person to the ambulance officers. |
Benzodiazepines Brand Names
Some commonly used brand names for Benzodiazepines used in the United States of America are;
| Alprazolam IntensolAtivanDalmaneDiastatDiazepam IntensolDizacDoralHalcionKlonopinLibriumLorazepam Intensol | NiravamPaxipamProSomRestorilSeraxTranxene-SDTranxene-SD Half StrengthTranxene T-TabValiumXanax |