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What are benzodiazepines, and how do they work? Benzodiazepines are a class of drugs primarily used for treating anxiety, but they also are effective in treating several other conditions. The exact mechanism of action of benzodiazepines is not known. All benzodiazepines affect gamma-aminobutyric acid (GABA), a neurotransmitter chemical that nerves use to communicate with one another. Since scientists believe that excessive activity of nerves in the brain may be the cause of anxiety and other psychological disorders, and GABA reduces the activity of nerves in the brain, benzodiazepines may be working by increasing the effects of GABA in the brain and spinal cord. For what conditions are benzodiazepines used? Benzodiazepines are used for treating: •anxiety, •seizures, and •insomnia. They also are used for: •general anesthesia, •sedation prior to surgery or diagnostic procedures, •muscle relaxation, •alcohol withdrawal, •nausea and vomiting, •depression, and •panic attacks. Are there differences between benzodiazepines? Benzodiazepines differ in how quickly they work, and for what they are most commonly used. •Diazepam (Valium) and clorazepate (Tranxene) have fast onsets of action, •oxazepam (Serax) has a slow onset, and •lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin) have intermediate onsets of action. Although most benzodiazepines are used interchangeably, some are most commonly used for certain conditions. •Alprazolam (Xanax), chlordiazepoxide (Librium), chlorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and midazolam are used for anxiety disorders; •clonazepam (Klonopin), clorazepate (Tranxene), and diazepam (Valium) are used for seizure disorders; •estazolam, flurazepam, quazepam (Doral), temazepam (Restoril), and triazolam (Halcion) are used for insomnia; •midazolam, lorazepam (Ativan), and diazepam (Valium) are used in anesthesia; •diazepam (Valium) also is used for muscle relaxation; •chlordiazepoxide (Librium) is used for alcohol withdrawal. What are the side effects of benzodiazepines? The most common side effects associated with benzodiazepines are: •sedation, •dizziness, •weakness, and •unsteadiness. Other side effects include: •a feeling of depression, •loss of orientation, •headache, and •sleep disturbance. All benzodiazepines can cause physical dependence. Suddenly stopping therapy after a few months of daily therapy may be associated with withdrawal symptoms which include a feeling of loss of self-worth, agitation, and insomnia. If benzodiazepines are taken continuously for longer than a few months, stopping therapy suddenly may produce seizures, tremors, muscle cramping, vomiting, and sweating. In order to avoid withdrawal symptoms, the dose of benzodiazepines should be tapered slowly. With which drugs do benzodiazepines interact? All benzodiazepines cause excessive sedation when combined with other medications that slow the brain's processes (for example, alcohol, barbiturates, narcotics, and tranquilizers). The elimination of some benzodiazepines [for example, alprazolam (Xanax) and diazepam (Valium)] is reduced by drugs that slow elimination of drugs in the liver [for example, ketoconazole (Nizoral, Xolegel), valproic acid (Depakene, Stavzor), cimetidine (Tagamet), and fluoxetine (Prozac). Reduced elimination may result in increased blood concentrations and side effects of the affected benzodiazepines. Antacids may reduce the rate of absorption of benzodiazepines from the intestine. Separating the administration of antacids and benzodiazepines may prevent this interaction. What are some examples of benzodiazepines? Alprazolam (Xanax) Chlordiazepoxide (Librium) Clonazepam (Klonopin) Clorazepate (Tranxene) Diazepam (Valium) Estazolam (Prosom) Flurazepam (Dalmane) Lorazepam (Ativan) Midazolam Oxazepam (Serax) Temazepam (Restoril) Triazolam (Halcion) Quazepam (Doral) |