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What Are Benzodiazepines?

written by: Jean Scheid • edited by: Paul Arnold • updated: 3/6/2011

Have you been prescribed a benzodiazepine and are wondering what are benzodiazepines, how do they work and what are they prescribed for? If so, here you’ll find out the answers to all your questions in this benzodiazepine FAQ.

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    Defining Benzodiazepines

    Medication Benzodiazepines are in the depressant family of drugs and are considered a Class 4 drug by the US Drug Enforcement Agency (DEA) and National Institute of Mental Health (NIMH). Types of benzodiazepines vary and those that work fast and efficiently in the body—usually within 15 to 20 minutes include ProSom (estazolam) Dalmane (flurazepan), Restoril (temazepam), Halicion (triazolam), and Versed (midazolam).

    Other benzodiazepines work on a slower basis and include Clonazepam (Klonopin) Xanax (alprazolam) Librium (chlordiazepoxide), Tranxene (clorazepate), Valium (diazepam), Paxipam (halazepam), Ativan (lorzepam) Serax (oxazepam) and Doral (quazepam). While a patient may feel the effects of Valium within 30 minutes, a Klonopin may take up to an hour to work depending on the dosage1.

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    How Do Benzodiazepines Work?

    According to the NIMH, benzodiazepines target the neurotransmitters in the brain known as Gamma Amino Butyric Acids (GABA). Patients that suffer from panic attacks, anxiety disorders, including generalized anxiety disorder or GAD), often experience overactive GABA neurotransmitters and benzodiazepines help to decrease excitatory transmission.

    Benzodiazepines are first absorbed through the stomach, reach the small intestine and are metabolized in the liver. Because they are a highly soluble drug, they can excrete through urine, breast milk and even sweating.

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    What Are Benzodiazepines Prescribed For?

    In a broad range, benzodiazepines are often used for insomnia and epileptic patients. In the mental health world, they are used to help prevent or stop anxiety or panic attacks. Many times, benzodiazepines are used in conjunction with anti-depressants or SSRIs such as Lexapro (escitalopram), Celexa (citalopram), Paxil (paroxetine), Prozac (fluoxetine), and Zoloft (sertraline) to help control anxiety disorders associated with depression.

    Benzodiazepines have showed promise in those suffering from severe anxiety or agoraphobia. Patients suffering from Borderline Personality Disorder or BPD that display episodes of anger or confusion are often calmed via the use of benzodiazepines.

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    Dosages of Benzodiazepines

    The dosage of every benzodiazepine is the decision of a qualified physician or psychiatrist as each comes in various milligrams that should not be decided by the layperson. For example, 0.5 mgs of Xanax is comparable to 10 mgs. Valium1.

    Some benzodiazepines will work on some where others won’t and like many SSRIs it may take trial and error to find the right type and dose of benzodiazepines.

    If a patient has been on long-term use of benzodiazepines, they may need to scale down on the dosage in steps to avoid withdrawal symptoms and the stepping down of dosages should be overseen by a qualified physician.

    In an one journal article that appeared in the Journal of Royal College of General Practitioners, a large percent (57.5%) of patients who stopped taking a benzodiazepine reported insomnia, dysphoria, muscle pain, and headaches2., This revelation alone is enough for those on long-term use of benzodiazepines to seek help from physicians that understand the inner workings of this drug.

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    References

    1. Robert Franklin, MD telephonic interview.
    2. Tyrer, Rutherford, Huggett - Benzodiazepine Withdrawal, Lancet (1999) (pp. 520-522) retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1711840/pdf/jroyalcgprac00004-0029.pdf
    3. NIMH - http://www.nimh.nih.gov/health/publications/mental-health-medications/what-medications-are-used-to-treat-anxiety-disorders.shtml
    4. Professor C. Heather Ashton, DM, FRCP - "Benzodiazepines, How They Work and How to Withdraw." Retrieved at http://www.bcnc.org.uk/equivalence.html.
    5. How do Benzodiazepines Work retrieved at http://www.reconnexion.org.au/how-do-benzodiazepines-work/w1/i1001212/

    Image Credit: Medications/MorgueFile/ronnieb