Benzodiazepine
Benzodiazepines, sometimes called "benzos", are a class of psychoactive drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. The first such drug, chlordiazepoxide, was discovered accidentally by Leo Sternbach in 1955, and made available in 19…
Full Answer
Can benzodiazepines be used to treat panic disorder?
Benzodiazepines may also be prescribed for other conditions. Examples of benzodiazepines used for the treatment of anxiety related to panic disorder or other anxiety disorders include: Xanax (alprazolam) Klonopin (clonazepam) Valium (diazepam) Ativan (lorazepam)
What is an example of a benzodiazepine?
Examples of Benzodiazepines Common uses for benzodiazepines include the treatment of anxiety, panic attacks, and insomnia. 2 Examples of benzodiazepines used for the treatment of anxiety-related to panic disorder or other anxiety disorders include: 2 Xanax (alprazolam): Prescribed for short-term relief of anxiety symptoms
Are benzodiazepines right for You?
Benzodiazepines, also known as benzos, are powerful medications that treat anxiety very well. There are many different kinds, and the differences between them are important. There are also some serious risks to using them. This guide will help you decide whether benzodiazepines are right for you. What is anxiety?
Can you take a benzodiazepine with an antidepressant?
To manage this side effect, a benzodiazepine is frequently prescribed along with the antidepressant, to be taken “as needed” for anxiety or on a scheduled regimen to prevent panic attacks. For most people, as the antidepressant takes effect, the benzodiazepine dose can be gradually reduced or taken less often.
For which reason are benzodiazepines used to treat anxiety?
What does Anti-anxiety Medications (Benzodiazepines) do? Benzodiazepines enhance the activity of the neurotransmitter GABA—a chemical in the brain that helps you to feel calm. Their effect also produces drowsiness, making it easier to fall asleep and sleep through the night.
Which condition is best treated with benzodiazepines?
Doctors often prescribe them to treat anxiety, seizures, and insomnia. The short-term use of these medications is usually safe and effective, but long-term use can lead to tolerance, dependence, and other adverse effects. There are different types of benzodiazepines, and they have different uses.
What is benzodiazepine used for?
Benzodiazepines are a type of sedative medication. This means they slow down the body and brain's functions. They can be used to help with anxiety and insomnia (difficult getting to sleep or staying asleep).
Why benzodiazepines are preferred over barbiturates?
Benzodiazepines and the newer non-benzodiazepine hypnotics are now preferred over barbiturates for most of these clinical uses because they have a wider therapeutic index, tolerance develops more slowly, and their liability for abuse is lower than that of the barbiturates.
When is it appropriate to prescribe benzodiazepines?
Benzodiazepines are useful for the short-term treatment of anxiety, insomnia, agitation, seizures, muscle spasm as well as the management of alcohol and other drug withdrawal. However, they should be prescribed with caution as dependence is common and can develop quickly and easily.
Which is the main action of benzodiazepines?
Benzodiazepines are a group of CNS depressants which induce feelings of calm (anxiolysis), drowsiness and sleep. They act by facilitating the binding of the inhibitory neurotransmitter GABA at various GABA receptors throughout the CNS.
What are the effects of benzodiazepines?
Effects of long-term benzodiazepine use feeling dulled and slow. feeling isolated and unreal. feeling cut off from your emotions. feeling irritable and impatient.
How do barbiturates work?
Barbiturates increase the activity of a chemical in the brain that helps transmit signals. This chemical is known as gamma amino butyric acid (GABA). As a medication, they reduce muscle spasms, relieve anxiety, prevent seizures, and induce sleep.
Why do doctors prescribe benzodiazepines?
Benzodiazepines are commonly used to treat anxiety and sleep disorders, as well as a number of primary medical conditions. However, they are often prescribed to patients who either do not have a clear indication1 or have poor indications such as depression.
When are barbiturates used?
Barbiturates are a group of sedative-hypnotic medications used for the treatment of seizure disorder, neonatal withdrawal, insomnia, preoperative anxiety, induction of coma for increased intracranial pressure. They are also useful for inducing anesthesia.
Why did benzodiazepines replace barbiturates quizlet?
Terms in this set (5) Benzodiazepines replaced barbiturates primarily because they were believed to be safer. Ambien (zolpidem) is a popular benzodiazepine used to treat anxiety. Among the sedative-hypnotic drugs, short-acting barbiturates seem to be the most likely to lead to drug dependence.
How are barbiturates different from benzodiazepines quizlet?
Barbiturates cause all 6 stages of arousal scale (wake, sedation, sleep, anesthesia, coma, death). Benzos only cause sedation and sleep.
What is the best medication for anxiety?
Benzodiazepines are regularly prescribed along with antidepressants to treat the symptoms of anxiety and panic disorders. The first choice antidepressants for generalized anxiety and panic disorder are selective serotonin reuptake inhibitors (SSRIs, such as sertraline or escitalopram) or serotonin-norepinephrine reuptake inhibitors (SNRIs, such as venlafaxine). Their downside, however, is that they take two to four weeks to start working, and up to eight weeks for full effects. Also, SSRIs and SNRIs can cause a temporary increase in anxiety in the first few weeks. To manage this side effect, a benzodiazepine is frequently prescribed along with the antidepressant, to be taken “as needed” for anxiety or on a scheduled regimen to prevent panic attacks. For most people, as the antidepressant takes effect, the benzodiazepine dose can be gradually reduced or taken less often.
Why do people stop taking benzodiazepine?
People may become reliant on their benzodiazepine, and may be reluctant to stop because of their understandable fear that anxiety or panic attacks may return. The risk of physical or psychological dependence is another reason why medication should not be the only tool for managing anxiety and panic disorders.
The short answer... yes, but..
Benzodiazepines, also known as benzos, are powerful medications that treat anxiety very well. There are many different kinds, and the differences between them are important. There are also some serious risks to using them. This guide will help you decide whether benzodiazepines are right for you.
Why trust us
Dr. Anthony Cull has been treating patients and teaching medical students and resident doctors as a board-certified physician for over a decade. He is a faculty member in the Department of Psychiatry at Oregon Health & Science University in Portland, Oregon, and he also maintains a private practice.
The complete answer
Benzodiazepines, or benzos, are a class of medications that have been around since the 1950s. They are used to treat anxiety, among other medical conditions, but can cause serious problems like abuse and addiction. They work by stimulating brain cells that communicate using a natural chemical called GABA (gamma-aminobutyric acid).
How we decided
We started by looking at some facts about anxiety from organizations like the ADAA, APA, NIMH, and WHO. The APA also has guidelines for the treatment of different anxiety conditions, created by experts in those conditions.
Keep in mind
Benzos can be very helpful medications, but they are also very powerful and can cause tolerance, withdrawal, dependence, and addiction. These are the main ways to avoid these problems:
Other choices
Other treatments for anxiety are less risky and can be taken safely long term. Here are some of those alternatives:
What's ahead
Scientists are researching many new ideas for treating anxiety besides benzos and the other choices you just read about. These include:
Which benzodiazepines work better?
Because of this, some benzodiazepines work better than others in the treatment of particular conditions. Common examples of benzodiazepines include alprazolam (brand: Xanax), diazepam (brand: Valium) and lorazepam (brand: Ativan). Common benzodiazepine uses: for sleep.
How do benzodiazepines work?
Benzodiazepines appear to work by blocking excessive activity of nerves in the brain and other areas in the central nervous system.
What is the purpose of Flumazenil?
Flumazenil (Romazicon - brand discontinued) is used to reverse the sedative effect of a benzodiazepine when used for a medical procedure and for treatment in a benzodiazepine overdose. Flumazenil blocks the central effect of benzodiazepines by competitive interaction at the benzodiazepine receptor site.
How do benzodiazepine hypnotics differ from diazepam?
The benzodiazepine hypnotics shorten the time it takes to fall asleep and prolong the sleeping period. The main differences exist in how long they might remain in the body, possibly leading to prolonged side effects. For example, lorazepam has a much shorter duration than diazepam, allowing quicker clearance of the drug and theoretically less side effects. On the other hand, diazepam can remain in the system for days and boost the risk for long-term side effects, especially in the elderly.
Why do benzodiazepines increase in CYP3A4?
If benzodiazepines that are CYP3A4 or CYP2C19 substrates are used with another drug that inhibits (blocks) these enzymes, drug levels of the benzodiazepine may rise due to decreased metabolism and excretion . High drug levels mean a greater risk for side effects.
What is Clobazam used for?
Clobazam (Onfi) is used as an add-on (adjunct) benzodiazepine anticonvulsive treatment with other seizures medications in the treatment of Lennox-Gastaut syndrome. Nayzilam (midazolam) and Valtoco (diazepam) are nasal sprays now approved for the treatment of seizure clusters (also known as acute repetitive seizures).
What is the half life of benzodiazepines?
Table 1: Common Benzodiazepines Available in the U.S. *The half-life is the amount of time it takes for half of the drug to be eliminated from the body. The shorter the half-life, the quicker the drug is eliminated, and the faster any bothersome side effects can subside.
Some Antidepressants for Anxiety
Antidepressants like Tofranil (toluene), Anafranil (clomipramine), and Norpramin (nortriptyline are examples of benzodiazepines that are often prescribed to treat anxiety). While these drugs can have an instant calming effect on the patient, they can also be habit-forming and thus they are only prescribed regularly for a short period of time.
Benzodiazepines for Panic Attack
Other benzodiazepines are used to prevent panic attacks from occurring in the first place. Which benzodiazepine is best for panic attacks? Again, it really depends on the particular patient. In general, people who suffer from generalized anxiety disorder will find that one type of therapy will be more effective than another.
How long does it take before any effects begin to be felt?
These vary greatly among patients. Some will notice their symptoms diminish after only one night of taking the benzodiazepine. Others may take as many as four or five nights and still feel relatively normal. The length of the effect will depend on the specific type of benzodiazepine taken, as well as age, health, and how often the drug is taken.
Who Should Avoid Benzodiazepines
However, there are some patients who should never take this type of medication. These include those with kidney or liver disease or any kind of chronic liver condition. Also, patients who have a history of allergies to benzodiazepines should avoid them.
Which benzodiazepine is best for anxiety?
This again will depend on the patient, but there are several types that can help ease anxiety symptoms. Ativan, Xanax, and Klonopin are common benzodiazepines and work in a different way than the others.
Overview
- Benzodiazepines are a class of medications that work in the central nervous system and are used for a variety of medical conditions, such as anxiety, seizures, and for alcohol withdrawal. Benzodiazepines appear to work by blocking excessive activity of nerves in the brain and other areas in the central nervous system. As a class, benzodiazepines ar...
Introduction
- Benzodiazepines are a large drug class and have a long history of development, starting with the first FDA-approvals in the 1960s, chloridiazepoxide (Librium) and diazepam (Valium). There are many options available within the class, and most benzodiazepines are now available generically, making them very affordable.
Prevention
- In the past, benzodiazepines, especially when used as a sedative-hypnotic for sleep, were touted as safer alternatives to the older barbiturates, which could lead to fatal overdose, particularly when combined with alcohol. Traditional benzodiazepines taken alone are rarely associated with lethal overdoses, but when combined with other sedatives or alcohol, the risk greatly increases. …
Prognosis
- *The half-life is the amount of time it takes for half of the drug to be eliminated from the body. The shorter the half-life, the quicker the drug is eliminated, and the faster any bothersome side effects can subside.
Mechanism of action
- Benzodiazepines work in the central nervous system, selectively occupying certain protein areas in the brain called GABA-A receptors. There are three types of GABA (gamma-aminobutyric) receptors in the brain: GABA-A, GABA-B, and GABA-C. GABA is the main inhibitory neurotransmitter in the brain (a chemical that help to block a nerve action). GABA helps to regul…
Signs and symptoms
- Alcohol withdrawal is diagnosed in a patient with a history of heavy and prolonged alcohol use and a sudden reduction or complete abstinence from alcohol. Alcohol withdrawal produces changes in the body, such as:
Treatment
- Medications such as benzodiazepines are a first-line treatment for acute alcohol withdrawal. Benzodiazepines reduce withdrawal symptoms and may be life-saving for the patient. Commonly used medicines in this group include: chlordiazepoxide (Librium), diazepam (Valium), and lorazepam (Ativan). Lorazepam (Ativan) or oxazepam (Serax) may be preferred in patients with l…
Epidemiology
- Anxiety and worry is a common problem in adults; however, when chronic, unwarranted worry lasts for a period of six months or longer and interferes with normal daily activities, this may be diagnosed as Generalized Anxiety Disorder (GAD). GAD is the most frequent anxiety disorder, affecting 6.8 million adults or about 3% of the U.S. population, but more than half remain untreat…
Medical uses
- Antidepressants (SSRIs/SNRIs) are considered first-line therapy for most patients, and benzodiazepines may play an adjunctive role in the treatment of GAD to address acute symptoms while the antidepressant takes effect. Only short-term use of low-dose benzodiazepines (2 to 6 weeks) is recommended, with a slow, gradual tapering once the antidepressant effect takes hol…
Effects
- The patient may remain awake but sedated, and usually there is no recollection of the procedure. Most patients can respond to verbal cues or tactile commands. This type of sedation allows the patient to recover more quickly from anesthesia, but they will need someone to drive them home and are usually drowsy until the next day, so will need to take a full day off of work. There is nor…
Side effects
- Drowsiness, sleepiness, or dizziness are the most commonly reported side effects with this drug class. Driving or operating machinery or perform other hazardous tasks can be dangerous while using these drugs. Drinking alcohol in combination with benzodiazepines may heighten these effects. Unusual sleep behaviors and anterograde amnesia may occur with traditional benzodiaz…
Contraindications
- 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. In general, benzodiazepines should NOT be used in pregnancy.
Interactions
- Important: Many drug interactions can occur with benzodiazepines; therefore, a drug interaction screen completed by a healthcare provider is an important step each time a new drug is added or discontinued in any treatment regimen. Many traditional benzodiazepines are broken down in the liver and when combined with drugs that block this action, blood levels can rise, leading to side …
Examples
- Examples of other drugs that may be additive to the central nervous system depression if combined with benzodiazepine include: Examples of drugs that are considered CYP3A4 inhibitors include: Examples of drugs that are considered CYP2C19 inhibitors include:
Adverse effects
- Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.