Benzodiazepines: what they are, uses, side effects and risks (2023)

general description

Was it a benzodiazepine?

Benzodiazepines are drugs that make the nervous system less active. By decreasing the activity of the nervous system, these drugs are useful for a variety of symptoms and conditions.

Many countries, including the United States, classify benzodiazepines (also known by the colloquial term "benzos") as controlled substances. That means you need a prescription to get them. It is illegal to have or get them without a prescription (depending on the laws of where you live).

IMPORTANT: Benzodiazepines are subject to controls because they can have dangerous effects, especially if used incorrectly.You can also create habits. Because of these factors, doctors use benzodiazepines with caution. When the activity of your nervous system decreases too much, it can have dangerous or even fatal consequences.

How do benzodiazepines work?

Your nervous system uses chemical and electrical signals to send and transmit messages throughout your body. Chemical signals, so-called neurotransmitters, can bind to cells via the corresponding receptors. Neurotransmitters and receptors work in a similar way to car keys. Neurotransmitters (your car keys) only fit into the right receptor (your car's ignition). If it fits, the neurotransmitter can start a process in the cell (start your car).

Benzodiazepines instruct the brain to release a neurotransmitter, gamma-aminobutyric acid (GABA). This neurotransmitter has a specific function: it reduces the activity of the nervous system. Slowing down activity can have the following effects:

  • amnesia: This word comes from a Greek word meaning "forgetfulness." Benzodiazepines temporarily block the formation of new memories (so-calledlower degree amnesia).
  • anxiolytisch: This term is a combination of two Greek roots, "anxio" for "fear" and "litico" for "to loosen". Drugs with this effect "loosen" the grip of fear on you while you are active.
  • Hypnotisch: Although many people associate "hypnotic" with practicingHypnosis, this word actually comes from the name Hypnos, the Greek god of sleep. Like their namesake, hypnotics cause drowsiness.
  • tranquilizers: This term comes from a Latin word meaning "to settle." In this regard, benzodiazepines help to "calm down" the nervous system and have a sedative effect.

Other ways of classifying benzodiazepines

Experts classify benzodiazepines essentially in two ways:

  • Fortaleza: Some benzodiazepines are stronger than others (although effectiveness may vary from person to person for various reasons). For example, 15 milligrams (mg) to 30 mg of flurazepam generally equates to 0.25 mg to 0.5 mg of clonazepam.
  • duration of the promotion: Some benzodiazepines are short-acting, lasting only a few hours. Some have a long-lasting effect, lasting several days. Most long-acting benzodiazepines are not that strong.

The strength and duration of action of benzodiazepines are important for the conditions they treat. Short-acting or emergency cases generally warrant the use of stronger, short-acting benzodiazepines. Chronic, non-emergency conditions can usually be treated with lower potency, longer acting benzodiazepines.

What diseases are treated with benzodiazepines?

These drugs treat medical conditions based on the effect they cause. While there are different types as they have different primary effects, there is a lot of overlap between them. For example, most benzodiazepines also have a sedative effect in addition to their primary effect.

  • amnesia: These are common for beginnersgeneral anesthesiabefore surgery and other medical procedures.
  • anxiolytisch: Treat itAnxiety disorders, ifSocial Anxiety DisorderJAnxiety Disorder.
  • Hypnotisch: Treat itinsomniaand related sleep disorders.
  • tranquilizers: This effect has many uses. It can treat conditions and symptoms related to muscle control, such as:muscle cramps. It can also treat more serious problems, such as:Katatonie(which is common in mental illness, e.gschizophreniaOBipolar disorder). These benzodiazepines are also very important in treatmentto attack(including those due toEpilepsy) jStatus epilepticus, a medical emergency related to a seizure.

What Are Non-Benzodiazepines?

Some drugs mimic the hypnotic effects and work similarly to benzodiazepines, but they are not the same. Experts call them non-benzodiazepines. These drugs also activate the same receptors as benzodiazepines, releasing GABA. Because of the way they work, these drugs are more effective in treating insomnia and related sleep disorders. They contain:

  • Esopiclon(Lunesta®).
  • Zaleplon(Sonata®).
  • Zolpidem(Ambien®).

Are benzodiazepines commonly prescribed?

Yes, benzodiazepines are commonly prescribed and widely used. Experts estimate that in a twelve-month period from 2014 to 2015, at least 30.5 million people in the United States took benzodiazepines prescribed by a healthcare provider.

Which benzodiazepines are most commonly prescribed?

Some of the most widely approved benzodiazepines in the US include (but are not limited to):

  • Alprazolam (Xanax®): Approved for the treatment of anxiety disorders, panic disorders andPremenstrual dysphoric disorder.
  • Chlordiazepoxide (Librium®; the brand name is no longer available in the US): Approved for the treatment of alcohol withdrawal and anxiety.
  • Clobazam (Onfi®, Sympazan®): Approved for the treatment of seizures and certain types of epilepsy.
  • Clonazepam (Klonopin®): Approved for the treatment of agitation, anxiety and seizures.
  • Clorazepato (Tranxene®): Approved for the treatment of anxiety and epileptic disorders.
  • Diazepam (Diastat®, Valium®, Valtoco®): Approved for the treatment of alcohol withdrawal, seizures and muscle spasms. Also approved for use as a pre-anesthetic during surgery and procedures. These can also treat the toxic effects of chloroquine and hydroxychloroquine on the heart.
  • Estazolam (ProSom®; the brand name is no longer available in the US): Approved for the treatment of insomnia.
  • Flurazepam (Dalmane®; the brand is no longer available in the US): Approved for the treatment of insomnia.
  • Lorazepam (Ativan®, Loreev®): Approved for the treatment of seizures, nausea and vomiting associated with chemotherapy, anxiety, pre-anesthetics during surgeries and procedures, and phobias.
  • Midazolam (Nayzilam®, Seizalam®, Versed®; the brand name Versed is no longer available in the US): Approved for the treatment of seizures, sedation of people on a ventilator and as pre-anesthesia for surgeries and procedures.
  • Oxazepam (Serax®; the brand is no longer available in the US): Approved for the treatment of alcohol withdrawal syndrome, anxiety and agitation.
  • Quazepam (Doral®): Approved to treat insomnia and trouble sleeping.
  • Remimazolam (Byfavo®): Approved for preoperative anaesthesia.
  • Temazepam (Restoril®): Approved for the treatment of insomnia.
  • Triazolam (Halcion®): Approved for the treatment of insomnia.

Unauthorized benzodiazepines

Many benzodiazepines are not approved for use in the United States. Some of these are legal in other countries, others are not legal anywhere.

A notable benzodiazepine, although unlicensed (and illegal) in the United States, is flunitrazepam. This drug is more commonly known as Rohypnol (or "roofies" in the slang term) and is known for its use as "date rapeDrugs. As such, flunitrazepam is a well-studied drug in the United States (and in many parts of the world). Health care providers can test for it and treat people who are under its influence (see What Are Its Drawbacks, side ) effects and possible complications of benzodiazepines?"). " Beyond).

Risks / Benefits

What Are the Benefits of Benzodiazepines?

Benzodiazepines have several benefits:

  • They have an established history.. Benzodiazepines have been widely used since the 1960s. Because of their decades of use, these drugs are well studied and understood.
  • She'They are much safer than their predecessors.. Before benzodiazepines, doctors mainly prescribed barbiturates to treat anxiety. However, these medications carry a significant risk of side effects and complications. Polish-American scientist Leo Sternbach accidentally discovered the first benzodiazepine, chlordiazepoxide, while looking for an alternative to barbiturates.
  • They treat many diseases.. Benzodiazepines are useful in treating many conditions, some of which are likely to occur simultaneously. An example is the common combination of fear of surgery and the need for sedation before anesthesia, both of which can be treated with benzodiazepines such as diazepam or midazolam.
  • There is an antidote for everyone.. There is a risk of overdose with benzodiazepines. However, a drug called flumazenil is an antidote that quickly reverses the effects of all benzodiazepines.

What are the disadvantages, side effects and possible complications of benzodiazepines?

Benzodiazepines are useful and effective, but come with some risks, including:

  • There is a possibility of abuse. Abuse of benzodiazepines is widespread. Experts estimate that at least five million people abused benzodiazepines in the 12-month period between 2014 and 2015 in the US.
  • You can create habits. Benzodiazepine use disorder is a potential complication of long-term or inappropriate use of these drugs.
  • There is a risk of overdose. The abuse of benzodiazepines can be dangerous as it can lead to an overdose that can lead to breathing problems.
  • They can have dangerous interactions with alcohol and certain medications.. Benzodiazepines can interact with medications such as opioid pain relievers (such as oxycodone or hydrocodone) or with alcohol. Such interactions can enhance the effects of drugs and/or alcohol, which can be fatal.
  • they are checked. These drugs are typically subject to regulatory oversight and restrictions based on the laws of your location. While there are legal restrictions to prevent abuse, they can also make it difficult for people taking these drugs for medical reasons to follow their prescriptions.
  • They can be used in sexual abuse.. The best known example of this is flunitrazepam, also known as Rohypnol. This drug prevents the formation of new memories and induces sedation, both reasons why it is used by sex offenders. However, the perpetrators of these crimes also use other benzodiazepines, such as clonazepam and diazepam. Research shows that abusers may also use non-benzodiazepine drugs such as zolpidem for similar reasons.
  • They may affect your ability to drive or perform certain tasks.. Benzodiazepines do not affect your alertness, but they do slow down nerve signals. Delayed nerve signals can slow down your reflexes, making it difficult or impossible to drive or perform certain tasks safely. Your doctor can advise you if it is safe to drive while taking a benzodiazepine medication.

Why can't I take benzodiazepines?

There are many reasons why you should not take benzodiazepines. These include:

  • possible interaction. If you are taking any medications, such as opioid pain relievers, ask your doctor about possible interactions between these medications and benzodiazepines. While providers are often cautious about these drugs, you can also protect yourself. Talking to your doctor to make sure you understand the potential risks can help you avoid problems if a doctor doesn't know about all the medications you're taking. Possible examples include an emergency room visit while traveling or if your doctor mistakenly prescribes you a benzodiazepine while taking opioid painkillers, or vice versa.
  • like you'You are pregnant or could become pregnant.. Benzodiazepines can alter fetal development in a way that is dangerous to the fetus or the pregnant person. Sellers can still recommend them in limited options situations. Nevertheless, you should generally avoid these medicines during pregnancy or if you plan to have children.
  • Other diseases or conditions that may affect benzodiazepines. Benzodiazepines can increase the problems of other diseases. People with balance or movement problems may be more prone to falls as a result of taking benzodiazepines.

What should I not eat or drink while taking benzodiazepines?

You should not drink alcohol while taking benzodiazepines. Alcohol can interact with these medications and cause complications or dangerous side effects. There may be other circumstances where you should not take benzodiazepines with certain foods or drinks. Your doctor can answer questions about whether you should change your eating or drinking habits while taking these medications.

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How long can I continue taking benzodiazepines?

Because benzodiazepines carry a greater risk of abuse and can become a habit, doctors tend to prescribe them with caution. They may prescribe them only when needed, rather than daily, and they may prescribe lower doses or choose benzodiazepines that are not as strong. Your doctor can explain his recommendations for your treatment, including the treatment plan and why.

Can I work or drive while taking benzodiazepines?

Your doctor will probably advise you not to work or drive immediately after you start taking benzodiazepines. You may be able to return to work or drive after you start, depending on how these drugs affect you, the dose you take, how long you take the drugs, and other factors.

Talk to your doctor before driving, returning to work, using heavy tools and machines, or engaging in other potentially hazardous activities. They can show you what you can do to take your medication as instructed and still stay safe.

When should you call the doctor?

When should I see my doctor?

Your doctor will schedule follow-up visits after prescribing benzodiazepines. It is important that you perform these visits as recommended. In some areas, providers cannot prescribe these medications without first seeing you for a follow-up evaluation. Your doctor can give you more information about the laws that apply to prescribing these medicines and the recommended time for you to return for a follow-up visit.

Frequently Asked Questions

Can I become dependent on benzodiazepines?

Yes, benzodiazepines can become a habit. Taking these drugs exactly as instructed makes this unlikely, but possible. Your doctor can give you more information about what you can do to avoid becoming addicted to these medicines or developing a benzodiazepine use disorder.

Can I experience benzodiazepine withdrawal symptoms?

Yes, withdrawal is a possible complication of benzodiazepine abuse. Unfortunately, this is also possible with long-term use of these drugs, even when taken as directed. If you are concerned about benzodiazepine addiction or withdrawal symptoms, your doctor can help you develop your treatment plan. They may also recommend that you switch to longer-acting benzodiazepines, as they are less likely to cause withdrawal symptoms.

Which benzodiazepine is most commonly prescribed?

According to a 2016 study, the most commonly prescribed benzodiazepines are:

  • Lorazepam (51%).
  • Clonazepam (20%).
  • Diazepam (14%).
  • Alprazolam (14%).

Together, these four drugs account for 99% of benzodiazepine prescriptions.

What can I do to prevent dangerous benzodiazepine-related events?

IMPORTANT: Due to the risk of abuse, overdose, or other dangerous events associated with benzodiazepines, it is important that you take steps to protect yourself and others. The main things you can do include:

  • Use these medicines exactly as prescribed.. This is the best way to reduce the risk of side effects and complications.
  • Keep these medications in your home and closely monitor access to them.. The most common way people can get benzodiazepines through abuse is by getting these drugs from medicine cabinets or other unsafe places in the homes of family members, friends, and other loved ones.
  • If you have any questions about addiction, talk to your healthcare provider.. Healthcare providers know that addiction is a potential complication of using benzodiazepines. Your doctor's job is to care for your health and well-being, not to judge you. If you have questions about addiction, talk to your doctor. They can help you by recommending a treatment plan, lowering your dose, or switching you to a drug with less dependency potential.

How to protect yourself from unwanted exposure to benzodiazepines

Benzodiazepines can pose a danger without you realizing it. Precautions are one of the best ways to protect yourself from taking these drugs without knowing it.

A "flavored" drink, that is, one that has a drug added to it without your knowledge, poses a danger to anyone, regardless of sex or gender. Also keep in mind that you may not be able to tell the difference from an alcoholic beverage.

The following precautions can help anyone avoid accidental consumption of a drug-influenced drink:

  • Save your drink. When you're out in public, such as in a bar, at a large social gathering, or at a party, don't leave your drink unattended for a second. When talking to someone, cover your drink with your hand or with an object such as a coaster. It only takes a fraction of a second to add a splash to a drink. So the best way to avoid splashing is to pour it yourself or watch the drink flow to your hand.
  • Don't accept anything to drink from anyone.. In many drug cases involving date rape, the perpetrator was no stranger. The attacked person may even mistake the attacker for a friend.
  • Don't use shared containers. Spilling a drink from a punch, can or similar is a potential hazard.
  • Don't risk it.If there's even the slightest chance that someone has added an additive to your drink, don't drink it. If you think you have consumed alcoholic beverages, seek help immediately. If you are with someone and think that person has been drinking, ask them for help right away.

A note from the Cleveland Clinic

Benzodiazepines are among the most commonly prescribed medications. They are an important tool in the treatment of many conditions, from mental disorders to brain diseases. While these drugs can treat many conditions and help millions of people, they are not without risk. If your doctor prescribes any of these medicines for you, do not hesitate to seek advice and take the medicines exactly as prescribed. This way you can take advantage of these drugs and reduce the chance of problems later on.


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