First developed in the 1960s, benzodiazepines were intended to replace other tranquilizers like barbiturates. Common benzodiazepines include Xanax, Klonopin, Ativan, Valium and Librium. (1) Generally prescribed for anxiety disorders and sometimes insomnia, they proved safer than the older medications. By the 1980s the medical community had a much better understanding of how addictive benzodiazepines are. Science also began to explore the long-term effects of benzodiazepine use. However, it wasn’t until the 2000s until pharmaceutical companies began to develop more effective non-narcotic alternatives that could still abate anxiety. Benzodiazepines still have not been replaced and are in wide use, though doctors are much more aware of their habit-forming nature than in the past.
All benzodiazepines work essentially the same way. They increase activity at receptors for the neurotransmitter gamma-aminobutyric acid (GABA). This suppresses the activity of neurons in the brain and slows down the central nervous system (CNS). This can help mitigate anxiety and lessen the intensity of a panic attack. But, like any psychiatric medication, benzodiazepines have side effects.
The short-term side effects include:
- Mental confusion
- Slowed breathing
- Motor control and coordination problems
In higher doses or when combined with other depressants, benzodiazepines can be extremely dangerous. Many opioid overdose deaths involve benzodiazepines as well because the compound effect of both increases the odds of respiratory depression (cessation of breathing). A high dose of benzodiazepines alone can cause fatal respiratory depression.
Many patients who are prescribed benzodiazepines end up taking them daily and become dependent upon them. Physical dependence is almost universal after a couple of months of use. Benzodiazepines are one of only a few classes of drugs that actually have potentially fatal withdrawal symptoms. The others being alcohol and barbiturates. It is absolutely vital that a person who takes benzodiazepines daily does not abruptly quit taking them. There is a potential for deadly seizures. However, it is possible to medically detox off of benzodiazepines safely. This should always be done under medical supervision. An inpatient setting is ideal for medical detox, but there are outpatient options available as well.
Habitual use of benzodiazepines, whether prescribed or otherwise, often has long-term effects. Aside from physical addiction, the effects of long-term use vary from person to person. They also depend upon the specific medication taken, the amount and duration of use.
The long-term side effects of benzodiazepines include:
- Memory impairment
- Difficulty concentrating
- Sexual dysfunction
- Coordination and motor skills problems
Generally, these effects are not permanent. But people who use higher doses of benzodiazepines over many years tend to have a long road to recovery. Because of these side effects and the addictive nature of these medications, doctors are more hesitant to prescribe benzodiazepines for long-term use now. They are still prescribed sometimes, especially for short term use, and when a patient does not have a history of substance abuse. Fortunately, there are alternative medications that are effective at treating anxiety and insomnia and do not have the perils of addiction that benzodiazepines do. (2) Buspirone and Ramelteon are just two examples. Several newer antidepressants such as Zoloft, Lexapro, and Celexa have been proven effective for General Anxiety Disorder (GAD) and can be taken safety for years.
Anxiety can be tough to manage and it can have a detrimental effect on a person’s quality of life. But psychopharmacology is an ever-evolving science and there are also natural compounds and practices, such as meditation, which can be truly helpful. There are many options to treat anxiety effectively and regain the joy of living again. If you or someone you know is dependent on benzodiazepines, please feel free to call us to discuss options for treatment.