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Benzodiazepines (“Benzos”) are drugs that were first marketed in the 1960’s for the treatment of insomnia, anxiety, seizures, convulsions and as muscle relaxants. Today these drugs account for about one out of every five prescriptions for controlled substances.
Benzos like ProSom, Dalmane, Doral, Restoril and Halcion are often prescribed for insomnia. Klonopin is often prescribed for the treatment of seizure disorders. Ativan, Centrax, Librium, Paxipam, Serax, Valium, and Xanax are often prescribed for the treatment of anxiety.
Intended to be used for a short time, they are often prescribed for longer and longer times. The longer that the Benzos are prescribed, the more likely that there are underlying medical issues that are undiagnosed.
Gamma-aminobutyric acid (“GABA”) is a neurotransmitter. A neurotransmitter is a chemical that is stored in cells. The neurotransmitters are sent from one cell to another cell and communicate what actions the receiving cell is supposed to perform. GABA is made in the brain from glutamate, an amino acid, with the aid of vitamin B6. There are inhibitory neurotransmitters which act to inhibit or slow the actions of other cells. There are excitatory neurotransmitters which act to speed up other cells.
GABA can act in some parts of the body as an excitatory neurotransmitter but in the brain of adults it is an inhibitory neurotransmitter. It causes signals to be sent that slow down activities of cells. GABA actually isn’t the producer of the inhibitory actions. When GABA binds to a nerve cell receptor, it is opening a path into a nerve cell so that chloride ions present in the brain are allowed to move into the nerve cell, contact a receptor in the cell, slow the activity of the cell and the person normally experiences a calming feeling. By counteracting the excitatory neurotransmitters, GABA helps create feelings of relaxation, pain relief and allows one to sleep.
HOW ARE BENZOS METABOLIZED?
Benzos are metabolized, for the most part, through the P450 pathway in the liver and primarily by the CYP3A enzyme. Because so many drugs and other substances are metabolized primarily by the CYP3A enzyme, there is a high likelihood that there will be interference either with the metabolism of Benzos or with the metabolism of other drugs and substances by Benzos.
HOW DO BENZOS WORK?
Again, as their drug labels state, no one knows exactly how Benzos work. However, we know that a benzodiazepine, like alcohol and opioids, is a Central Nervous System (CNS) depressant. Anything that depresses the CNS will seem to relax a person. Benzos increase the effect of GABA on the cell and this allows more than the usual number of chloride ions to reach the cell receptor and further reduce the activity of the cell. For many, the feeling created by Benzos is similar to the feeling many of us experience if we are drinking alcohol.
However, Benzos are not harmless drugs. Government studies show that a large percentage of drug-related emergency room visits involve Benzos. Like alcohol, using Benzos impairs mental alertness and physical coordination and can dangerously compromise mechanical performance, such as automobile driving.
Combining the use of Benzos and alcohol can have fatal consequences. In addition, because of the effect created by Benzos, a large percentage of people entering treatment for narcotic or cocaine addiction also report abusing Benzos. This is certainly consistent with our experience at Novus.
SIDE EFFECTS OF BENZOS
There are many side effects that have been reported for Benzos. Here are some of the more common:
- aches and pains (muscle tension)
- blurred vision
- bradycardia (slow heartbeat/pulse)
- changes in appetite (increase or decrease)
- decrease in libido (sex drive)
- diarrhea and constipation
- dysphoria (depression)
- hypotension or hypertension (blood pressure, hypo = low and hyper = high)
- impairment of motor co-ordination
- incontinence (inability to control urination)
- numbed emotions
- panic attacks
- suicidal thoughts
Common Features of Benzodiazepine Withdrawal
There is a wide range of symptoms that can occur in people withdrawing from Benzos and symptoms vary from one individual to another. The most common of these are anxiety and insomnia. Other common symptoms are taken from our medical protocol and listed below.
Common withdrawal symptoms include:
- agoraphobia (fear of public places)
- anxiety (most common)
- feelings of unreality
- hallucinations (visual or auditory)
- hypersensitivity to noise/light/touch
- memory impairment
- obsessive negative thoughts (particularly of a violent and/or sexual nature)
- panic attacks
- suicidal thoughts
- tremors (uncontrollable shaking of the body)
Onset and Duration
Withdrawal typically occurs within two days after ceasing short-acting Benzos, and usually between two and ten days after ceasing long-acting Benzos. However, the onset of Benzo withdrawal may be as late as three weeks after cessation of Benzos. This is particularly true of Xanax withdrawal.
Withdrawal from short-acting Benzos (e.g. oxazepam, temazepam, alprazolam, lorazepam) typically produces a faster and more severe onset of symptoms than withdrawal from long-acting Benzos (e.g. diazepam, nitrazepam) and may be more difficult to complete.
The severity of withdrawal is highly variable and is generally dependent on the elimination rate (half-life), the dose of the drug, duration of use, and the rapidity of cessation or reduction in use. Other important factors include physical illness, pre-existing anxiety or mood disorders and dependence on other psychoactive substances. A person’s environment and support network will also influence perceptions of withdrawal severity.
Novus Medical Detox Center has developed protocols that greatly ease withdrawal from Benzos. However, withdrawing is normally only a first step. It is important that people coming off Benzos obtain very thorough medical exams to find out if there is an underlying medical condition that is causing the symptoms that the Benzos were taken to address. The Benzos really don’t cure the cause but may mask it for a time.
At Novus we are excited that we can help people withdraw from drugs and start them on their journey to be drug-free. This is true if it is an alcohol detox, OxyContin detox, Vicodin detox, Xanax detox, methadone detox, Paxil detox, or Lexapro detox. We are here to help you.
NOTE: This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine, health care diagnosis or treatment, or (iii) the creation of a physician patient or clinical relationship. If you have or suspect that you have a medical problem or that this information may be useful to you or others, please consult with your health care provider before applying any information from our articles to your personal situation or to the personal situation of others.
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