Benzodiazepines: Uses, Dangers, and Clinical Considerations PMC

Withdrawal reactions can also occur if the drug is stopped suddenly, especially those that are shorter-acting. Discontinuation of a benzodiazepine should be done gradually under a doctor’s direction. There is normally no need to aid breathing in conscious sedation; however, a deeper level of sedation may rarely occur, therefore respiratory and resuscitative equipment should severe benzodiazepine withdrawal syndrome always be available to healthcare providers. 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. If you are pregnant or are thinking about becoming pregnant, talk to your OBGYN or psychiatrist about your plans.

Mechanism of Action

Beware of online pharmacy purchases; in general, consumers in the U.S. should only purchase medications from their local pharmacy or health-plan administered mail-order pharmacy. As noted in the Boxed Warnings, concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. In the elderly, benzodiazepines and nonbenzodiazepine agents should be avoided, as recommended by the Beers Criteria, an expert opinion-developed guideline addressing safe drug use in the elderly.

4. Complications of Benzodiazepine Abuse

One study compared the mainstay of treatment with a standardized interview/counselling approach to treatment [72]. The experimental group in this study had a weekly 1/10-dose reduction after a 2 week stabilization period [72]. The experimental treatment also included a BZD diary, a drinking diary, BZD withdrawal education, and assessments for ways of coping and “progressive relaxation exercise” [72]. This was compared to a gradual taper without the other components of the treatment plan [72]. There was no difference in the success rate of BZD discontinuation between the control and experimental groups in this case [72]. A person with panic disorder has panic attacks which are repeated episodes of intense fear which may be expected or unexpected.

Side effects

Some people develop a paradoxical reaction to benzodiazepines – this is the opposite reaction to what you would expect. They may become agitated or very anxious, develop hallucinations, have difficulty sleeping or exhibit bizarre behavior such as taking off their clothes in public or taking unnecessary risks. To avoid withdrawal symptoms, your doctor will slowly lower the dosage of the benzodiazepine. There are three kinds of benzodiazepines, each of which has a different half-life. The half-life is the amount of time that elapses before only half of the drug’s dosage remains active in your body.

• Neurotransmitters (your car key) can only fit into the right receptor (your car ignition).
• This call to action proves especially relevant, as those seeking treatment for BZD dependence and withdrawal are on the rise in the United States.

What are the most commonly prescribed benzodiazepines?

Your healthcare provider can answer questions about whether to change what you eat or drink while taking these medications. Benzodiazepines are a class of medications that slow down activity in your brain and nervous system. They’re most often used for treating anxiety and related mental health conditions, as well as brain-related conditions like seizures. These medications are tightly regulated and are only available with a prescription. Depending on which benzodiazepine you are currently taking, your doctor may want to switch you to a different one before your taper begins. Short-acting benzodiazepines complicate withdrawal with too many ups and downs.

In a systematic review of research, Charlson et al. could not find conclusive evidence supporting increased risk of mortality in BZD users [43]. In their analysis of six retrospective studies, half of them showed no significant relationship between BZD use and mortality. One of the studies showed an increase in mortality with increased dosage and frequency of use which could be attributed to increased toxicity, another showed a positive correlation among older adults [43]. One of the study’s limitations is the inability to collect data that differentiate mortality correlation with illicit BZD use from the use of prescribed pills.

Are benzodiazepines commonly prescribed?

Diazepam, a long-acting benzodiazepine, is the most common choice for dose tapering. Problems start to arise when benzodiazepines are taken at higher dosages than recommended, or when they are taken for more than two to four weeks. 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.

For example, midazolam is given by injection and often used alongside anesthesia medications because it works quickly to cause sleepiness. Some drugs may intensify the effects of benzodiazepines, while others may make them less effective. If you use any of these drugs for too long, you can experience symptoms of withdrawal if you suddenly stop. Long-term use of benzodiazepines can lead to adverse behavioral symptoms and drug dependence. While they’re effective in treating these conditions for a short time, benzodiazepines may cause frustrating side effects like drowsiness, loss of libido, and lack of coordination.

Benzodiazepines should only be taken at the lowest dose for the shortest possible length of time. Benzodiazepines (also called “benzos”) are a class of agents that work in the central nervous system and are used for a variety of medical conditions. If you’re taking a benzodiazepine, check with your doctor to see if it’s safe to drive a vehicle, operate machinery, or perform activities that require a focus on details. However, the AGS considers antidepressants Silenor (doxepin) and Remeron (mirtazapine) as good and safe options for treating insomnia in older people. Benzodiazepines are often classified by their onset of action—how quickly they begin to work after you take them. Benzodiazepines, as a class, work on a certain type of receptor found throughout your brain and spinal cord, which make up the central nervous system.