The benzodiazepine class of drugs is used in a variety of health problems. That said, they are known to cause dependence, tolerance, and withdrawal effects.
Benzodiazepine is a psychoactive medicine used to treat insomnia, anxiety, and a range of other conditions. These are some of the most commonly prescribed medications in the U.S., mainly among elderly patients. Current studies reveal that the use of benzodiazepine for prolonged periods to treat insomnia and anxiety increases the risk of developing Alzheimer’s disease, a form of dementia. Now, dementia is the main cause of dependency in older people, affecting 36 million people worldwide. This figure is expected to double every two decades.
What are benzodiazepines and their uses?
Benzodiazepines are a group of drugs that work on the central nervous system(CNS). They act selectively on gamma-aminobutyric acid-A (GABA-A) receptors in the brain. They potentiate the effect of GABA, an inhibitory neurotransmitter, hence preventing neuronal excitation and giving calmness. Different benzodiazepines impart similar pharmacological actions but have different potencies, so they have multiple uses, such as anticonvulsants, sedatives, hypnotics, anxiolytics, and muscle relaxants.
What are the different types of benzodiazepine?
Benzodiazepine may be classified based on mode of action. The different types of benzodiazepines are as follows:
- Short-acting compounds: triazolam
- Medium-acting compounds: estazolam
- Long-acting compounds: diazepam, flurazepam
What are the benzodiazepine side effects?
Though benzodiazepine classes of drugs have a range of pharmacological actions and tend to be well tolerated, they have side effects, too, that you must know before taking them. The possible associated side effects of benzodiazepine are listed below:
- Benzodiazepine addiction
Despite its many uses, benzodiazepines can cause physical as well as psychological addiction. When benzodiazepines are administered regularly for a long period, the body becomes accustomed to the presence of the drug, and the person seeks the drug for normal physiological functioning. This is known as physical dependence. Tolerance and withdrawal are the signs of physical dependence. Aside from these signs, the following are the signs and symptoms of benzodiazepine addiction.
- The person continues to use the medication even after knowing or suffering from ongoing or frequent physical or psychological problems.
- Intake of the larger amounts of drug than prescribed.
- Intake of drugs for longer periods.
- The person loses social interest and takes it aside from social, work, recreational, or school activities.
- Benzodiazepine tolerance
Prolonged use of benzodiazepine causes tolerance. The longer you take the drug, the greater the chances of developing tolerance. Though tolerance is a gradual process, it may develop rapidly within a few weeks. In this condition, the drug’s action does not come from the usual dose, and the body responds only to the extended dose.
- Benzodiazepine withdrawal
Commonly known as “Benzo withdrawal,” it is a group of symptoms that come out when a person is taking a benzodiazepine, has developed dependence, and undergoes dose reduction or discontinuation of the drug. The symptoms that emerge due to Benzo’s withdrawal are sleep disturbance, irritability, increased tension, anxiety, panic attacks, hand tremors, confusion, cognitive difficulty, sweating, difficulty with concentration, memory problems, muscular pain and stiffness, dry retching and nausea, weight loss, palpitations, headache, hallucinations. These withdrawal symptoms may last a few weeks to one year. The best solution to prevent the withdrawal effect is to taper off the dose at a sensible rate. However, this unnecessary stretch in tapering may also develop withdrawal effects.
• Cognitive impairment
The current studies have made known the eye-opening fact that prolonged users of benzodiazepine are more prone to develop dementia. In the last 15 years, dementia was diagnosed considerably more often in benzodiazepine users than in nonusers (32% vs. 23%)1. Though the causal relationship and pathophysiological relevance are not yet clear, the following facts can correlate benzodiazepine to dementia.
- Benzodiazepine may influence the neurotrophic signaling linked to intense down-regulation of nerve growth factor-induced gene-A, BDNF, and transcription factor GIF.
- Benzodiazepine alters the functional properties of GABA-A that resemble these GABA-A receptor subunit alterations observed in Alzheimer’s disease.
- Benzodiazepine may regulate certain gene expressions and protein levels, which can disturb neuronal functioning.
- In some studies, benzodiazepines are found to cause mitochondrial dysfunction, and that is supposed to be a source of the free radicals initiating mental retardation that leads to dementia.
Other side effects at higher doses of benzodiazepine include:
- Drowsiness
- Confusion
- Dizziness
- Blurred vision
- Weakness
- Poor judgment and decision-making
- Slurred speech
- Lack of coordination
- Difficulty breathing
- Coma
- Death from respiratory arrest
Benzodiazepine is now an effective treatment option for many diseases, but unnecessary long-term use of these drugs should be considered a public health concern. If you are taking benzodiazepine, discuss with your physician routinely what changes you are facing in your daily life. Take only the prescribed dose up to the prescribed time. Be aware of the recurrent effects of medication to avoid future consequences.
Amelia Smith
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