Advantages and Drawbacks of Benzodiazepines

For many years, benzodiazepines have been the focus of both public and medical concern. The Centers for Disease Control and Prevention (CDC) estimate that over 92 million benzodiazepine prescriptions  ⁽¹⁾ were written in the US in 2019 alone But there are hazards associated with its extensive usage as well, such as dependency and a number of adverse consequences.

Benzodiazepines are a crucial topic for discussion because of the balance between their possible advantages and disadvantages. Continue reading to learn about the common kinds, applications, and hazards of benzodiazepines.

Benzodiazepines: What Are They?

The family of psychoactive medications known as benzodiazepines, or “benzos,” affects the central nervous system. They have a variety of effects, including as drowsiness, relaxation, and decreased anxiety. Because of the possibility of dependency, tolerance, and other negative side effects, benzodiazepines are typically not advised for long-term therapy, even if they may be useful for the short term in treating certain diseases including anxiety ⁽²⁾, sleeplessness, and seizures.

Benzodiazepine Types

Because benzodiazepines are available in a variety of formulations and have varying durations of action ⁽³⁾, they can be used to treat a range of medical conditions. Here are a few varieties that are frequently prescribed:

• Short-acting: alprazolam (Xanax) and triazolam (Halcion ⁽⁴⁾) are two examples. These are typically recommended to treat symptoms of anxiety and sleeplessness.
• Intermediate-acting: lorazepam (Ativan) and clonazepam (Klonopin ⁽⁵⁾) are two examples. They are frequently used to provide mildly prolonged relief from panic and anxiety disorders ⁽⁶⁾.
• Long-acting: diazepam (Valium) and chlordiazepoxide (Librium ⁽⁷⁾) are two examples. These are frequently used to treat muscular spasms, anxiety problems, and occasionally the symptoms of alcohol withdrawal.

What Is the Use of Benzodiazepines?

Benzodiazepines have anticonvulsant, muscle relaxant, sleep-inducing, and anti-anxiety effects. As a result, the following ailments are commonly treated with them:

1. Disorders of anxiety. The most prevalent conditions for which benzodiazepines are given are anxiety disorders, such as panic disorder, social anxiety disorder ⁽⁸⁾, and generalized anxiety disorder (GAD). Although they can quickly alleviate acute symptoms, they are often not advised for the long-term treatment of anxiety.
2. Sleeplessness. Certain benzodiazepines work well for treating insomnia, especially if it’s a sudden, severe episode. They improve the length and quality of sleep while also reducing the amount of time needed to fall asleep.
3. Disorders of seizures. To treat seizure disorders like epilepsy, certain benzodiazepines are used as anticonvulsants. They are usually regarded as secondary choices to other antiepileptic medications, though.
4. Spasms of muscles. When used to treat problems like spasticity or other types of dystonia, benzodiazepines help reduce tension and muscular spasms.
5. Medical treatments. In medical treatments that call for sedation or pain and anxiety alleviation, some benzodiazepines are employed. They are frequently employed in diagnostic tests including endoscopies, small surgical operations, and dental surgery.
6. Additional applications. Benzodiazepines are occasionally used to treat drug abuse-related disorders including the symptoms of alcohol withdrawal ⁽⁹⁾.

Given its potential for addiction, benzodiazepines may be carefully evaluated as part of a larger depression therapy strategy for those who are also suffering anxiety.

Benzodiazepines: How Do They Work?

Benzodiazepines mainly function by amplifying the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that is essential for reducing brain activity ⁽¹⁰⁾. Benzodiazepines can intensify the actions of GABA, leading to a variety of sedative, anxiolytic (anti-anxiety), and anticonvulsant effects. Because of this mechanism, benzodiazepines are useful in the treatment of disorders such as muscular spasms, anxiety, sleeplessness, and seizures.

Benzodiazepines’ benefits

Although benzodiazepines include certain hazards, such as tolerance, dependency, and misuse potential, they also provide a number of important benefits.

1. A comparatively quick start to activity. Compared to other drugs, many benzodiazepines can relieve acute symptoms (such as extreme anxiety or panic attacks ⁽¹¹⁾) more quickly. Keep in mind that various people may require different dosages, and it’s crucial to avoid taking more if the initial dose doesn’t have the intended result right away.
2. Adaptability in action duration. Because benzodiazepines come in both short-acting and long-acting forms, customized therapy regimens are possible. For insomnia ⁽¹²⁾, for instance, short-acting benzodiazepines could be the better option.
3. Adaptability. Beyond treating anxiety and sleep problems, prescription benzodiazepines have other uses. They serve as muscle relaxants, sedatives for specific medical operations, and aid in the treatment of alcohol withdrawal.
4. Accessible in several formats. The administration of oral benzodiazepines is made flexible by the availability of pills, injectables, nasal sprays, and under-the-tongue formulations.
5. Quite safe when taken in excess. Benzodiazepines are typically safer than other sedatives like barbiturates, although overdose is a severe risk with any medicine. This does not, however, exclude the possibility of benzodiazepine overdose, particularly when paired with other drugs that depress ⁽¹³⁾ the central nervous system, such as alcohol or opioids.

Effects of Benzodiazepines on Patients

Even while benzodiazepines can be quite helpful, it’s vital to be mindful of the possible negative effects that could result from using them. The frequency and severity of these side effects ⁽¹⁴⁾ might vary, so it’s important to speak with a healthcare professional for individualized medical advice. Some of the adverse effects  are listed here, divided into significant and common categories.

Overdosing on Benzodiazepines

Benzodiazepine overdose ⁽¹⁷⁾  can be a dangerous and even fatal circumstance. Overdose symptoms might include:

• Severe fatigue or sedation.
• Inability to coordinate and confusion.
• Speech slurred.
• Breathing that is extremely shallow or sluggish.
• Unresponsiveness or coma.

Risk elements:

• Taking more medication than is advised.
• Combining benzodiazepines with other drugs, especially opioids or alcohol.
• Prolonged benzodiazepine usage.

In the event of an overdose, prompt medical intervention is essential. As soon as you suspect an overdose, contact emergency services or visit the closest emergency facility.

Dependency and Tolerance to Benzodiazepines

With prolonged usage, benzodiazepine dependency can develop, resulting in a physical and psychological reliance on the drug. Withdrawal symptoms, including increased anxiety, sleeplessness, and, in extreme situations, seizures, may arise if the medicine is stopped suddenly.

Because benzodiazepine tolerance  ⁽¹⁸⁾ can occur somewhat fast, higher dosages could be needed over an extended period of time to have the same therapeutic benefit. A vicious cycle of dose increases may result from this, raising the possibility of dependency and other negative consequences.

Medical supervision is the most effective method of managing benzodiazepine tolerance and dependency. To safely lower the dosage, your doctor could suggest a gradual tapering regimen.

Misuse of Benzodiazepines

Research indicates that 20% of benzodiazepine usage results in abuse, which can take many different forms:

• using drugs without a prescription ⁽¹⁹⁾.
• using it in ways that are not recommended, such as taking larger dosages, breaking apart tablets, or combining it with other drugs.
• consuming it recreationally to get a “high.”

Overdose, dependency, and a plethora of other mental and physical health issues are just a few of the detrimental effects that misuse may cause. ⁽²⁰⁾

When a Patient Is Eligible for a Prescription Benzodiazepines

The most frequent conditions for which benzodiazepines are given include muscular spasms, seizures, sleeplessness, and anxiety disorders ⁽²¹⁾. They are occasionally used as a premedication for medical operations or as a temporary remedy for severe stress. However, these drugs are often not advised for the long-term treatment of chronic illnesses because of the possibility of dependency.

Before prescribing benzodiazepines, doctors take into account several criteria, such as your medical history, the severity of your ailment, and any other drugs you may be on. Particularly for long-term management, they could choose other therapies, such as additional medications, including cognitive-behavioral therapy for sleeplessness or SSRIs for anxiety disorders.

Benzodiazepines During Breastfeeding and Pregnancy

There are hazards and difficulties associated with using benzodiazepines during pregnancy and lactation, such as low birth weight, and cleft palate.

Because benzodiazepines are secreted in breast milk and can impair the nursing infant, moms who are breastfeeding their babies should also be cautious. It is important to consult a healthcare provider in both cases for a personalized risk assessment and to explore alternative treatment options ⁽²²⁾.

Benzodiazepines Taken With Other Drugs

Think about possible drug interactions with other prescriptions when using benzodiazepines, such as:

• Opioids. Opioids and benzodiazepines together may cause severe respiratory depression.
• Medications for depression. Benzodiazepines and some antidepressants may interact, changing the former’s efficacy or intensifying its adverse effects.
• Alcohol. Alcohol and benzodiazepines should never be combined since doing so might cause severe drowsiness and possibly respiratory collapse.

Giving your doctor ⁽²³⁾ a complete list of all the prescriptions you use, including over-the-counter pharmaceuticals and herbal supplements, is critical. With this knowledge, they will be more equipped to decide if adding prescription benzodiazepines to your treatment strategy is safe and effective.

In conclusion

For a variety of medical conditions, including anxiety, sleeplessness, etc., benzodiazepines provide a powerful remedy. However, concerns include dependency, overdose possibility, and adverse effects offset their usefulness. When benzodiazepines are taken with other drugs or in situations like pregnancy, more caution is necessary. Benzodiazepine medications should thus be used under strict medical supervision and are often best used for short-term therapy.