Benzodiazepines
Most medications prescribed today to treat anxiety and insomnia belong to a group of drugs called benzodiazepines. Benzodiazepines work by calming your central nervous system. Frequently prescribed benzodiazepines include lorazepam (e.g., Ativan), alprazolam (e.g., Xanax), diazepam (e.g., Valium), temazepam (e.g., Restoril), and triazolam (e.g., Halcion). Often, their chemical names end in the letters "pam" or "am".
Used correctly, under the direction of your doctor, these medications are effective and safe. For anxiety and sleep problems, benzodiazepines are usually prescribed only for short periods - a few weeks or months. However, some people may need to take benzodiazepines for a longer period of time.
How will benzodiazepines affect me? The way these medications - or any other drug - affect you depends on many factors, including: the amount you take; how long you take a drug; whether you're also taking other medications or drugs; your age.
Benzodiazepines can help relieve sleep problems and symptoms of anxiety. They have also been used in the treatment of panic disorders, seizures and muscle spasms.
Generally speaking, a small dose tends to make you feel relaxed and calm. A larger dose may make you feel drowsy and clumsy.
These medications should be taken as directed by your physician. You should never take more than your doctor prescribes. Otherwise, you may become too sedated.
If you take benzodiazepines regularly (e.g., every day) for a long time, they may become habit-forming.
How safe are benzodiazepines? These medications are generally considered safe when taken as directed by your doctor. In current medical practice, they are usually prescribed in low dosages for short periods (i.e., a few weeks or months).
When you start taking a benzodiazepine, you may experience side-effects such as drowsiness, dizziness and light-headedness. You may be unsteady on your feet and less alert. Often these symptoms pass as your body adjusts. Until you are sure of your reaction to this drug, avoid driving and always use caution in tasks demanding alertness.
Side-effects concern everyone, especially seniors, who are more sensitive to the effects and side-effects of drugs. Some people may feel "hung over" on the day after taking the medication and may be more prone to falls and injuries. These issues may be of particular concern with long-acting benzodiazepines like flurazepam. It has also been suggested that benzodiazepines can impair the ability to learn and remember new information.
Benzodiazepines may be prescribed to relieve sleeplessness. But some people who have trouble sleeping may have a hidden reason for their insomnia (such as depression or another illness). A physician may prescribe benzodiazepines until the underlying reason for the insomnia is discovered. Then, a more appropriate treatment may be suggested. This is one reason that benzodiazepines tend not to be prescribed for long periods of time to treat insomnia.
Your doctor or pharmacist can warn you about medications to avoid while taking benzodiazepines. Benzodiazepines can increase the effects of alcohol and other drugs (e.g., cold, allergy and pain preparations, and other sleep medications).
Remember, avoid driving when you have taken a benzodiazepine and have also had some alcohol. Mixing benzodiazepines with other drugs may cause excessive drowsiness and potentially dangerous sedation.
An overdose of benzodiazepines can cause unconsciousness or even death. Warning signs that you've taken too much include: severe drowsiness; slurred speech; weakness and staggering.
If you notice any of these signs after taking the medication, contact your doctor.
A few people have experienced mental and behavioral changes while taking benzodiazepines. If you experience any changes in your behavior or mental state (such as confusion, bizarre behavior, aggression, etc.), consult your doctor immediately.
If you're taking benzodiazepines and are pregnant or thinking about becoming pregnant, talk to your doctor because they may affect your baby. For example, using benzodiazepines while you're pregnant can lead to withdrawal symptoms in your baby after it is born. Benzodiazepines are also passed on through breast milk. You shouldn't stop the medication on your own; check with your doctor first.
As with all medications, keep benzodiazepines out of the reach of children - they're more sensitive than adults to the effects of benzodiazepines.
Are benzodiazepines addictive? They can be. It depends on how much of the medication you take, how long you take it, and whether you have been dependent on any other drug.
If this medication is used regularly for more than a few weeks, your body may become used to the presence of benzodiazepines and you may feel that you need them.
To avoid becoming dependent on benzodiazepines, don't take more of the medication than your doctor prescribes, and don't take it more often or for longer than directed.
Do not stop taking benzodiazepines without first consulting your doctor. Stopping suddenly may bring on symptoms that are similar to conditions for which the medications were originally prescribed. Withdrawal symptoms can be mild (e.g., trouble sleeping, feeling unwell) or severe (e.g., anxiety, trembling, cramps), and, in rare cases after high doses are stopped quickly, psychosis and convulsions can occur.
Usually, physicians taper off the medication slowly, over time. Even then, there is a chance that you may experience some temporary discomfort. Any withdrawal symptoms will subside with time, as the body readjusts.
Regularly discuss your need for the medication with your doctor. Do not get your prescription for benzodiazepines refilled indefinitely at your pharmacy. In most cases, benzodiazepines do not need to be used for longer than four months. Are there alternatives to the use of benzodiazepines? Although some people with specific conditions might have to take benzodiazepines for a long period of time, others may benefit from alternatives to relieve anxiety and sleeplessness.
To relieve stress, it may be useful to: try relaxation exercises and tapes, take long walks, find new interests and hobbies, and talk about your troubles with a friend.
People who take benzodiazepines to help them sleep may find that the medication is less effective after a few weeks. For a more permanent solution, and as an alternative to drug therapy, consider the following tips: exercise regularly and get some fresh air during the day, but avoid strenuous activity before bed; avoid naps during the day; have a warm glass of milk or a light snack before bed; take a warm bath before bed; try not to dwell on your problems at night; share your worries with close friends; make your sleeping area a comfortable, soothing place; keep alcohol and caffeinated drinks to a minimum, especially in the evening; go to bed when you are tired and not before; get up at the same time each morning; if you can't fall asleep, get up and do something relaxing until you are drowsy.
Also, remember that sleep patterns change as you get older. Seniors, for example, may not need as much sleep as they once did. If you have any concerns about your benzodiazpine use, consult your doctor or pharmacist.
Copyright © The Credit Valley Hospital