Benzodiazepines refers to a class of drugs primarily used for treating anxiety, but they also are effective in treating several other conditions. They work by regulating an extremely important signaling pathway in the brain. After a person ingests a benzodiazepine, it is metabolized by the body and modulates a protein on the surface of brain cells known as the gamma amino butyric acid (GABA)-A receptor.
GABA receptors normally bind to the most common neurotransmitter in the central nervous system known as GABA. When bound to its receptor, GABA exerts a calming effect on both the brain and central nervous system. If benzodiazepines are present in a person’s system, this calming effect is magnified and lasts longer than if GABA was present alone.
For what conditions are benzodiazepines used?
Benzodiazepines are used for treating:
- anxiety and panic
- seizures (convulsions), and
- insomnia or trouble sleeping.
They also are used for:
- general anesthesia,
- sedation prior to surgery or diagnostic procedures,
- muscle relaxation,
- alcohol withdrawal and drug-associated agitation,
- nausea and vomiting,
- depression, and
- panic attacks.
Are there differences between benzodiazepines?
Because of their calming effect, benzodiazepines can be used to treat many different conditions. Benzodiazepines’ mechanism of action is generally the same regardless of the condition for which they are prescribed. Typical effects associated with benzodiazepine use include feeling calm, relaxed, and tired. Benzodiazepines are prescribed to individuals for several common conditions including:
Anxiety treatment: There are both short and long-acting benzodiazepines that can help treat anxiety, severe anxiety or panic disorders depending on the needs of the patient. Additionally, many benzodiazepines are fast-acting meaning that they can relieve anxiety symptoms in a short amount of time. Since benzodiazepines help slow down the central nervous system, they “trick” the body into being more relaxed and less anxious. This can be extremely helpful for individuals with debilitating anxiety or panic attacks (e.g. Alprazolam, Chlordiazepoxide, Clonazepam, Diazepam, Lorazepam, Oxazepam).
Insomnia treatment: Many of the same benzodiazepines that are prescribed to treat anxiety can also treat co-occurring insomnia or a completely separate diagnosis of insomnia. Though all the causes of insomnia are not well understood, some types of insomnia can be directly caused by stress. Thus, by producing a relaxing and calming effect, benzodiazepines help individuals relax and reduce their stress levels with the overall goal of attaining a more quality sleep. Benzodiazepines that are faster acting but are eliminated from the body more quickly are generally quite effective at improving insomnia symptoms (e.g. Clonazepam, Lorazepam, Temazepam, Triazolam).
Seizure disorder: Some benzodiazepines may be prescribed to individuals who struggle with seizures. Severe seizures can be uncontrollable and cause severe physical injury. A benzodiazepine in this case, could help prevent bodily injury by relaxing a person’s muscles before, during and after a seizure (e.g. Clonazepam, Diazepam, Lorazepam).
Muscle spasms: Similar to patients with seizures, an individual who suffers from muscle spasms may also benefit from benzodiazepine treatment due to the relaxing effects of this drug class, individuals can get relief from tense muscles.
Drug or alcohol withdrawal treatment: Benzodiazepines may even be prescribed to individuals actively withdrawing from alcohol withdrawal. Particularly for severe alcohol withdrawal, patients may benefit from a benzodiazepine to ease some uncomfortable symptoms. As a result, individuals may feel more relaxed and that they can make it through the initial withdrawal process (e.g. Chlordiazepoxide, Diazepam, Oxazepam).
What are the side effects of benzodiazepines?
The most common side effects associated with benzodiazepines are:
- weakness, and
Other side effects include:
- transient drowsiness commonly experienced during the first few days of treatment,
- a feeling of depression,
- loss of orientation,
- sleep disturbance,
- excitement, and
- memory impairment.
NOTE: 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.