Benzodiazepines are widely used in medicine to treat anxiety and insomnia. These are synthetic substances normally seen as pharmaceutically-manufactured tablets, capsules and occasionally as injectables. They act as depressants of the central nervous system CNS. Chlordiazepoxide Librium was the first to be synthesised in and introduced into medicine in Benzodiazepines are under international control. The different drugs have varying substituents on this basic skeleton.
Diazepam CAS is one of the best known benzodiazepines Valium. Benzodiazepines are a group of CNS depressants which induce feelings of calm anxiolysis , drowsiness and sleep. There is no clear division between anxiolytics and hypnotics, since most anxiolytics will induce sleep if taken at night and most hypnotics will sedate when taken during the day.
Different benzodiazepines vary in the rate in which they are metabolised to pharmacologically active forms and particularly in their half-lives see Table 1 : short-acting drugs have a half-life of less than 24 hours e.
Such half-lives vary between individuals, and the elderly tend to eliminate these drugs much more slowly. They are thus more at risk from the side-effects which include drowsiness, ataxia staggering gait , mental confusion, impaired judgement and anterograde amnesia. There is a significantly increased risk of adverse events in the elderly such as falls, diminished cognitive function and driving impairment, although the latter is not confined to the elderly.
The European prevalence studies show that, excluding alcohol, benzodiazepines are along with cannabis the psychoactive substances most prevalent in the driving population. Experimental studies show that these drugs impair driving ability and when alcohol is also used, the risk of being involved in or responsible for a road accident is significantly increased. Benzodiazepine intoxication can be associated with behavioural disinhibition, potentially resulting in hostile or aggressive behaviour.
The effect is perhaps most common when benzodiazepines are taken in combination with alcohol. The combined use of alcohol and benzodiazepines also increases the risk of a fatal overdose because both act as CNS depressants. A similar fatal interaction can occur when opiates are taken with benzodiazepines as part of a pattern of polydrug use. Apart from the increased risk of fatal overdoses, the usual injection-specific diseases such as tissue damage, gangrene and transmission of HIV and hepatitis C also occur if the drugs are injected.
There is also the risk of cross-dependence developing to benzodiazepines. Medically, benzodiazepines should only be used for the short-term relief of anxiety or insomnia which is severe and disabling. This is because tolerance and dependence can occur just weeks after use has commenced.
Withdrawal signs and symptoms can be classified as major or minor, like those of the alcohol syndrome. According to that classification, minor symptoms include anxiety, insomnia and nightmares. Major symptoms include perceptual disturbances, psychosis, hyperpyrexia and life-threatening convulsions. However, forensic toxicology shows that only a very small number of such assaults actually involve the use of flunitrazepam.
Other work has identified covert use of benzodiazepines to facilitate theft. The synthesis of benzodiazepines is performed by the pharmaceutical and chemical industry, often using patented methods. While the vast bulk of benzodiazepines are manufactured pharmaceutically, information on Internet websites describes a series of routes to producing diazepam using 5-chloro-N-methyl-isatoicanhydride and 2-aminochlorobenzophenone as precursors.
Benzodiazepines are usually swallowed as tablets but can be injected for both medical and non-medical purposes and there are some reports of intranasal snorting misuse. Numerous synonyms and proprietary names exist for the 35 benzodiazepines under international control.
Flunitrazepam gives a pink colour. Benzodiazepines also give a reddish-purple or pink colour in the Zimmerman test. The major ions for temazepam molecular weight Find out here. A benzodiazepine overdose can lead to :. Anyone who shows signs of an overdose or an adverse reaction after taking benzodiazepines will need emergency medical help.
Before starting treatment with benzodiazepines, a person must tell their doctor about every other medication that they are using. Some drugs may intensify the effects of benzodiazepines, while others may make them less effective. It is essential not to use benzodiazepines with opioids or alcohol, as this can lead to life threatening effects.
People should also never combine them with cannabis use. Benzodiazepine misuse is a cause for concern. Some people use these drugs for recreational purposes without the supervision of a medical professional, which can be dangerous. Benzodiazepines can help treat some mental health and neurological conditions, but it is essential to use them with care. A person should always tell their doctor about any other drugs that they are using and seek medical help at once if any unexpected reactions occur.
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The benefits and risks of benzodiazepines. Medically reviewed by Alan Carter, Pharm. Uses Function Types Side effects Interactions Misuse Takeaway Benzodiazepines are a class of drugs that can treat a range of conditions.
Name Use alprazolam panic and anxiety disorders chlordiazepoxide Librium alcohol withdrawal and anxiety diazepam panic attacks, restless leg syndrome, insomnia, seizures, and alcohol withdrawal flurazepam Dalmane insomnia clonazepam panic disorder and seizure disorders lorazepam anxiety, seizures, and anesthesia temazepam Restoril insomnia.
Side effects. Exposure to air pollutants may amplify risk for depression in healthy individuals. Costs associated with obesity may account for 3. Related Coverage. Medically reviewed by Dena Westphalen, Pharm.
Treatments for anxiety. Medically reviewed by Dillon Browne, PhD.
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