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Drug lexicon

Benzodiazepines

Benzodiazepines are prescription drugs that are used as sleeping pills or sedatives. Due to their relaxing effect, they are also used as tranquilizers. to tranquillize = calm down). In 1957 the first substance from the group of benzodiazepines was synthesized with the active ingredient chlordiazepoxide and introduced into medicine in 1961 under the trade name Librium. Diazepam, better known under the brand name Valium®, followed in 1963. All other substances from the benzodiazepine class are derived from chlordiazepoxide and diazepam.

Area of ​​application and effect

Benzodiazepines primarily have an anxiety-relieving and calming effect. The threatening turns into an easily manageable unimportance, unrest disappears, fear dissolves. The main medical fields of application of benzodiazepines are therefore above all anxiety disorders, states of excitement, tension and restlessness as well as psychotic symptoms. Benzodiazepines are also used as a sedative before surgery, for epileptic seizures, tetanus, febrile convulsions and other conditions with increased muscle tone (muscle tension).

Benzodiazepines have a central nervous effect, i.e. they dock on receptors in the brain and cause a dampening of the transmission of stimuli. This happens mainly through a facilitated binding of the inhibitory neurotransmitter gamma-amino-butyric acid (GABA). This also influences downstream neurotransmitters such as noradrenaline, acetylcholine and serotonin. This has an impact on memory, attention and coordination of movements, as well as on the emotional life.

Risks

According to the profile of action, side effects also occur, especially at higher doses. These include tiredness, drowsiness, lightheadedness, and difficulty concentrating, as well as depression and memory lapses. In addition, there are disorders in the movement sequences, dizziness and muscle weakness, which increases the risk of falling. Other side effects include slow or slurred speech, blurred vision, nausea, diarrhea, dry mouth, increased appetite, slow breathing, and a drop in blood pressure.

Due to the reduced ability to react, the ability to drive is impaired, which increases the risk of accidents when driving vehicles or operating machines. The side effects can vary depending on the preparation used, which is why the instructions for use should be read carefully when prescribing. Benzodiazepines must not be taken in the case of certain illnesses such as disorders of the lung and respiratory functions (e.g. asthma) or muscle weakness.

Long-term use can lead to health problems. These include emotional dulling, concentration and memory problems, physical exhaustion as well as reduced ability to criticize, i. H. those affected hardly notice changes in themselves.

Interactions

Simultaneous use with other sedative (drowsy, sleepy) substances such as alcohol, barbiturates or opiates and certain antidepressants or antihistamines can fatally increase the depressant effect of the benzodiazepines. Breathing and cardiac arrest can result.

pregnancy and breast feeding period

Benzodiazepines and their metabolic products reach the unborn child via the placenta (placenta) and can accumulate there because the fetus breaks down benzodiazepines very slowly. In the newborn, this can lead to the so-called “floppy infant syndrome”, which is characterized by slack muscles, breathing difficulties and a disturbed sucking reflex. Benzodiazepines should therefore only be used during pregnancy if the doctor deems it absolutely necessary. Since benzodiazepines pass into breast milk, drugs of this type should be avoided entirely during breastfeeding.

Addiction

Benzodiazepines should only be used for a short time, as tolerance develops quickly, with the risk of developing psychological and physical dependence. It is estimated that around 1.1 million people in Germany are dependent on benzodiazepine preparations. The danger of developing dependency is especially given when benzodiazepines - also called "benzos" in scene jargon - are abused, ie not taken on the basis of a medical indication or in doses higher than the prescribed.

However, even with low doses prescribed by a doctor, addiction can develop. This is especially the case if, in the case of overly uncritical prescribing practice, the intake takes months or even years or other doctors are consulted for additional prescriptions because everyday life can no longer be managed without benzodiazepines. This process can take place slowly and unnoticed, as the dependence is often hardly noticeable in everyday life with a low dose.

The phenomenon of drug dependence is not due to individual causes, but is subject to a network of individual and social factors. It is known that the development of addiction is usually preceded by psychological problems. Women seem to be more affected. 70 percent of all drug addicts are female. In addition, the risk of drug addiction increases with age.

Withdrawal syndrome

The heavier the consumption, the more pronounced the withdrawal symptoms are when the drug is stopped. Important is: Benzodiazepines must not be discontinued suddenly! Medical supervision is strongly recommended. Withdrawal symptoms often resemble the original symptoms that led to taking the medication. These include sleep disorders, pain, restlessness, mood swings and irritability. The feelings of fear that were previously dampened by benzodiazepines can become more pronounced and even lead to panic attacks. There are also experiences of alienation, suicidal impulses and perceptual disorders. In rare cases, epileptic seizures and delusions can occur.


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