13 Feb Health Effects of Benzodiazepines
Benzodiazepines are a class of psychoactive medications that achieve their effects by altering normal function in certain portions of your brain and spinal cord (central nervous system). Doctors commonly prescribe these medications to treat problems that include anxiety, insomnia and seizures; they also sometimes use certain benzodiazepines for surgical sedation and anesthesia, as well as in the treatment of panic attacks, depression and the symptoms of alcohol withdrawal. Taken together, prescriptions of the various medications in this class account for a significant portion of all prescriptions written in the U.S. While benzodiazepines are generally effective, they present significant risks for a number adverse health consequences, including physical dependence and addiction.
Members of the benzodiazepine class include alprazolam (Xanax), triazolam (Halcion), lorazepam (Ativan), chlordiazepoxide (Librium), clonazepam (Klonopin), flurazepam (Dalmane), quazepam (Doral), and diazepam (Valium), as well as the illegal drug flunitrazepam (Rohypnol). These substances achieve their basic effects by changing the way in which your body uses a substance called gamma aminobutyric acid, or GABA, which naturally circulates in your central nervous system. GABA acts as a regulator of the communication rates between individual nerves in this system; when the overall pace of communication rises above a certain point, your body reduces activity by increasing GABA’s circulating levels. Subjectively, humans experience this GABA increase as a heightened sense of calm.
Benzodiazepines intensify the effects of GABA and trigger sedation by slowing normal function in the central nervous system, as well as in nerves in the rest of your body. Through additional chemical actions, these medications also reduce anxiety levels. Most common benzodiazepines have roughly the same overall effects; however, your body has varying levels of sensitivity to specific forms of these drugs, and absorbs and eliminates them at different rates. Doctors refer to members of the class that enter and leave the body relatively quickly as short- or medium-acting benzodiazepines, while members that get processed at a slower speed are known as long-acting benzodiazepines.
Potential Short-Term Effects
Potential short-term health effects of benzodiazepine use vary according to dosage. In people who take low or moderate doses, physical effects can include decreased body coordination, vision alterations, nausea, vomiting, constipation, diarrhea, abdominal distress, muscle tremors, stuttering, slurred or garbled speech, unusual fatigue, unusual sleepiness or drowsiness, tremors, and abnormally shallow breathing. Potential mental effects of low or moderate benzodiazepine doses include depression, confusion, thinking difficulties and memory disruption. People who take high doses of benzodiazepines have risks for all of the problems associated with low or moderate doses, as well as intense drowsiness, decreases in normal muscle reflexes, and mood swings that can lead to aggressive or unpredictable behavior.
Over-Sedation and Overdose
When legitimate or illicit users habitually take multiple doses of long-acting benzodiazepines (such as quazepam, flurazepam or clonazepam), these medications can accumulate in the bloodstream and eventually get stored in fat cells. If the stored concentration of these substances rises high enough, the user will develop a condition called over-sedation. Common symptoms of this condition include loss of normal muscle coordination, abnormal muscle weakness, slurred or garbled speech, mental disorientation and/or confusion, thinking difficulties, memory disruptions, and an inability to make rational judgments.
In addition to the gradual process of over-sedation, some benzodiazepine users take too much of their medication in a short span of time and experience an overdose. Apart from symptoms similar to those associated with over-sedation, potential consequences of this condition include abnormally shallow breathing, abnormally low blood pressure, and a form of involuntary eye movement known as nystagmus. By itself, a benzodiazepine overdose is not typically a life-threatening event; however, potential overdose consequences include coma, cardiorespiratory failure and death. People with the highest risks for these severe outcomes typically combine high benzodiazepine doses with tricyclic antidepressants, opioids, barbiturates or alcohol.
Dependence and Addiction
Common drugs of abuse such as marijuana, hashish, and opioids create the potential for physical dependence and addiction by increasing the presence of dopamine, a brain chemical (neurotransmitter) that plays a critical part in the human ability to experience pleasure. In effect, problems with dependence begin when the brain gets used to higher dopamine levels and subsequently reacts negatively when those levels drop. Problems with addiction begin when a dependent person develops persistent drug cravings and engages in reckless behaviors that center on using the drug in question. At one time, addiction researchers didn’t believe that benzodiazepines triggered dependence and addiction by altering dopamine levels. However, according to experts at the National Institute on Drug Abuse, these researchers now know that benzodiazepine medications do, in fact, increase dopamine levels through unique chemical pathways.
If physical dependence occurs in a benzodiazepine user who has only taken his or her medication for a few months or less, potential withdrawal symptoms include insomnia, agitation, and feelings of personal negativity. Potential withdrawal symptoms associated with longer-term use include sweating, vomiting, muscle cramps, tremors and seizures. Typically, the most severe withdrawal symptoms appear in people taking short- or medium-acting benzodiazepines. Doctors try to ease the effects of withdrawal by slowly reducing their patients’ benzodiazepine doses over relatively extended periods of time.
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