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What are Benzodiazepines?


Published: January 24, 2018

Benzodiazepines (Benzos) are a group of drugs used mainly to treat anxiety, but they are also used to treat other conditions, you can see those other conditions in the list below. According to Professor Heather Ashton, they either directly or indirectly affect almost every aspect of brain function.

anxiety

Benzodiazepines work by affecting neurotransmitters in the brain. Neurotransmitters are chemicals that brain cells (neurons) release to connect with other neurons. One of these neurotransmitters is gamma- amniobutyric acid (GABA) which suppresses the activity of neurons. GABA is called an inhibitory neurotransmitter because it tells the neurons to slow down and to stop firing. Benzodiazepines enhance the natural body chemical actions of GABA.

Benzodiazepines are marketed in 3 main categories anxiolytic, hypnotic and anticonvulsant but have other uses as can be seen below. They can be very effective for short term use (2-4 weeks maximum) but become very problematic for long term use because the body becomes tolerant  to th drug and require more of it to function effectively – this is called dependency.

benzodiazepines

The uses and categories are:

  1. Anxiolytic: Used for the relief of anxiety, examples are Xanax, Librium, Ativan, Serepax.
  2. Hypnotic: Used for the promotion of sleep: Estazolam, Prosom, Rohypnol, Nitrazepam, Mogadon, Temazepam, Restoril, Normison.
  3. Myorelaxant: For muscle spasms and spastic disorders: Valium is often used for this.
  4. Anticonvulsants: To stop fits and convulsions: Clobazam, Frizium, Klonopin,
  5. Amnesia – premedication for operations and sedation for minor surgery.

Halcion is often used by dentists however Halcion is in the hypnotic category.

There are also drugs that are non benzidiazepine but have similar effects called Z drugs: Zaleplon – Sonata; Zolpidem – Ambein, Stilnoct; Zopliclone – Zimovane, Imovane; Eszoplicone – Lunesta. They all fall within the hypnotic category.

Benzodiazepines vary in potency and how quickly they begin to work – some vary as much as twenty times in potency for an equivalent dose. For example, 0.5 milligrams of alprazolam (Xanax) is approximately equivalent to 10mg of diazepam (Valium), so a person taking the average prescription of 6mg of Xanax is taking the equivalent of 120mg diazepam which is a very high dose! Other potent commonly used benzodiazepines are alprazolam, lorazapam (Ativan) and clonazepam (Klonopin). The difference in potency is very important if a person chooses to taper from their drug. Valium is usually the drug of choice to taper from because it has a long half-life of 20-100 hours – meaning that the drug stays in the blood stream for a long time as opposed to Xanax which has a half-life of 6-12 hours. Crossing over to Valium can be problematic because 120 mg is very sedative, so many people choose to taper directly to reduce the cross-over dose. Some drugs like Halcion have a half-life of only 2 hours which is why they are often used by dentists in Australia. Halcion is banned in Britain and some other countries  probably because of the short half-life.

I hope that this brief overview clarifies what is going on in your brain. For a much more in depth understanding please refer to Professor Heather Ashton’s ‘Ashton Manual‘ which is the first link below.

References:
https://www.benzo.org.uk/manual/
https://en.wikipedia.org/wiki/Benzodiazepine
https://www.rxlist.com/benzodiazepines/drugs-condition.htm