Benzodiazepines for treating Anxiety
Posted 04-28-2008 at 05:09 PM by ladypam
The common medication usually prescribed for anxiety disorders are benzodiazepines. These are substances that are actually given not only as an anxiolytic but as a hypnotic, a myorelaxant, an anticonvulsant, and for amnesia. It is sometimes used for alcohol detoxification as well as acute psychosis. You can usually tell it belongs to the benzodiazepine family if its name ends in the suffix –am or –pam.
Benzodiazepines are found to be quite an effective treatment for anxiety so much so that patients get used to its effect and often end up having an addiction and tolerance to it. They have a low acute toxicity but when used for a long period of time, it may cause other side effects to occur on the body. In fact, some experts advise that benzodiazepines be taken only for a maximum of 2 to 4 weeks, depending on the degree of illness. More than this time period may lead to a tolerance to the medication.
What is anxiety?
Anxiety is described to be a disorder that may be ordinarily productive. It is often a cause for concern when it becomes psychologically paralyzing to the person. The person often cannot perform its normal duties and needs to take in medications in order to cope with this anxiety. They experience fast heartbeats, increased sweating, and sometimes nausea. Many other disorders are found to affect a patient suffering from an anxiety attack, which includes panic disorders and phobias. Benzodiazepines act to treat these disorders although in this article, its treatment on generalized anxiety will be the one discussed.
How do Benzodiazepines work?
Benzodiazepines work to reduce anxiety through binding with GABA receptors in the nerve cell to enhance the effect of GABA on the receiving nerve cell, which is to inhibit stimulatory effects. It is further enhanced by the increased entry of chloride ions that hyperpolarize the entire nerve cell, thus inhibiting the attachment of other neurotransmitters aside from GABA and further increasing the effect of GABA on the cells, producing a calming effect.
Diazepam
A very common medication, Valium has been seen to treat and alleviate symptoms of anxiety. It works through depressing the nerve pathways leading to the skeletal muscle to facilitate its relaxation. It is considered to be fast acting, and prone to abuse since it is habit forming. It is also used for panic disorders and night terrors, which are sleep disturbances in children. Common disadvantages associated with Valium are its withdrawal symptoms which are common with all benzodiazepines, relapse, and rebound anxiety. Its side effects include fatigue, drowsiness, blurred vision, dizziness, tachycardia, and the loss of the coordination of muscles. It can be administered in dosages of not more than 20 mg a day. It can take effect in as fast as 30 minutes and can last for the whole day.
Chlordiazepoxide
Indicated for generalized anxiety, chlordiazepoxide or brand name Librium gives the same side effects and disadvantages of all benzodiazepines. It needs to be taken at a greater dosage of about 25 mg in 2 to 4 doses in a day as compared to valium. It can be increased up to 200 mg in a day. These medications cannot be used by pregnant women, including women who are breastfeeding. Alcohol is also contraindicated with taking this medication. It may be given orally or intramuscularly although poor absorption is seen following the latter method.
Clonazepam
One of the faster acting benzodiazepines, Clonzapam as Klonopin can bring down anticipatory anxiety attacks, making it also useful for social anxiety phobia. It can also be used for panic disorder. It is seen to have a faster action as compared to Alprazolam. Aside from the usual side effects caused by most benzodiazepines, it can also lead to depression. Drowsiness is seen in almost half of the patients who are taking Clonazepam during the first couple of weeks of medication. Drinking alcoholic drinks together with this drug can bring about intoxication or even extreme drowsiness. The daily maximum dosage of Clonazepam ranges from 0.25 mg to 2 mg at most.
Lorazepam
Commonly prescribed as a treatment for seizures and epileptic episodes, Lorazepam, aka Ativan or Temesta is also used for panic disorders and generalized anxiety. This medication is known to have few side effects as compared to other benzodiazepines. Alcohol intake is allowed but should be used with caution. Side effects associated with lorazepam, aside from the common occurrences due to most benzodiazepines are weakness and disinhibition, wherein they do inappropriate acts or become out-of-control. The maximum dosage that can be given to patients is 10 mg daily but they should start with a minimum of 0.5 mg each night.
Oxazepam
Also for generalized anxiety, Oxazepam, or more commonly known as Serax, Serenid, Serepax, and Zaxopan can produce hypotension or a lowering of blood pressure, making it not a good choice of benzodiazepine if suffering from low blood pressure. But for hypertensive patients, it may cause a double beneficial effect. It is found to aggravate the effects of alcohol. The daily dose of this medication is at 10-30 mg given 3-4 times a day.
Other benzodiazepines for anxiety
Aside from the ones mentioned above, there are other benzodiazepines in the market that are less popular for use for several probable reasons such as causing too many side effects, too hard to find, too expensive to buy, have caused adverse effects on patients, was not really well known to doctors and pharmacists, or were initially good for anxiety but found better for other conditions. They are Broamzepam as Lexotan or Lexomil; Clobazam as Frisium; Clorazepate as Tranxene or Gen-Xene; Halazepam as Paxipam; Ketazolam as Anxon; Medazepam as Nobrium; Nordazepam as Nordaz or Calmday; and Prazepam as Centrax.
Alprazolam, commonly known as Zanax or Xanax is also a benzodiazepine that was first indicated for anxiety but since it was found to be better suited for the treatment of depression, it was thus prescribed for such.
Anxiety is a condition affecting a lot of people. It may be comforting to know that in some way, it can be treated and keep them free from anxiety. Medications are not always a sure way of treatment but at least it can do something to alleviate it.
Benzodiazepines are found to be quite an effective treatment for anxiety so much so that patients get used to its effect and often end up having an addiction and tolerance to it. They have a low acute toxicity but when used for a long period of time, it may cause other side effects to occur on the body. In fact, some experts advise that benzodiazepines be taken only for a maximum of 2 to 4 weeks, depending on the degree of illness. More than this time period may lead to a tolerance to the medication.
What is anxiety?
Anxiety is described to be a disorder that may be ordinarily productive. It is often a cause for concern when it becomes psychologically paralyzing to the person. The person often cannot perform its normal duties and needs to take in medications in order to cope with this anxiety. They experience fast heartbeats, increased sweating, and sometimes nausea. Many other disorders are found to affect a patient suffering from an anxiety attack, which includes panic disorders and phobias. Benzodiazepines act to treat these disorders although in this article, its treatment on generalized anxiety will be the one discussed.
How do Benzodiazepines work?
Benzodiazepines work to reduce anxiety through binding with GABA receptors in the nerve cell to enhance the effect of GABA on the receiving nerve cell, which is to inhibit stimulatory effects. It is further enhanced by the increased entry of chloride ions that hyperpolarize the entire nerve cell, thus inhibiting the attachment of other neurotransmitters aside from GABA and further increasing the effect of GABA on the cells, producing a calming effect.
Diazepam
A very common medication, Valium has been seen to treat and alleviate symptoms of anxiety. It works through depressing the nerve pathways leading to the skeletal muscle to facilitate its relaxation. It is considered to be fast acting, and prone to abuse since it is habit forming. It is also used for panic disorders and night terrors, which are sleep disturbances in children. Common disadvantages associated with Valium are its withdrawal symptoms which are common with all benzodiazepines, relapse, and rebound anxiety. Its side effects include fatigue, drowsiness, blurred vision, dizziness, tachycardia, and the loss of the coordination of muscles. It can be administered in dosages of not more than 20 mg a day. It can take effect in as fast as 30 minutes and can last for the whole day.
Chlordiazepoxide
Indicated for generalized anxiety, chlordiazepoxide or brand name Librium gives the same side effects and disadvantages of all benzodiazepines. It needs to be taken at a greater dosage of about 25 mg in 2 to 4 doses in a day as compared to valium. It can be increased up to 200 mg in a day. These medications cannot be used by pregnant women, including women who are breastfeeding. Alcohol is also contraindicated with taking this medication. It may be given orally or intramuscularly although poor absorption is seen following the latter method.
Clonazepam
One of the faster acting benzodiazepines, Clonzapam as Klonopin can bring down anticipatory anxiety attacks, making it also useful for social anxiety phobia. It can also be used for panic disorder. It is seen to have a faster action as compared to Alprazolam. Aside from the usual side effects caused by most benzodiazepines, it can also lead to depression. Drowsiness is seen in almost half of the patients who are taking Clonazepam during the first couple of weeks of medication. Drinking alcoholic drinks together with this drug can bring about intoxication or even extreme drowsiness. The daily maximum dosage of Clonazepam ranges from 0.25 mg to 2 mg at most.
Lorazepam
Commonly prescribed as a treatment for seizures and epileptic episodes, Lorazepam, aka Ativan or Temesta is also used for panic disorders and generalized anxiety. This medication is known to have few side effects as compared to other benzodiazepines. Alcohol intake is allowed but should be used with caution. Side effects associated with lorazepam, aside from the common occurrences due to most benzodiazepines are weakness and disinhibition, wherein they do inappropriate acts or become out-of-control. The maximum dosage that can be given to patients is 10 mg daily but they should start with a minimum of 0.5 mg each night.
Oxazepam
Also for generalized anxiety, Oxazepam, or more commonly known as Serax, Serenid, Serepax, and Zaxopan can produce hypotension or a lowering of blood pressure, making it not a good choice of benzodiazepine if suffering from low blood pressure. But for hypertensive patients, it may cause a double beneficial effect. It is found to aggravate the effects of alcohol. The daily dose of this medication is at 10-30 mg given 3-4 times a day.
Other benzodiazepines for anxiety
Aside from the ones mentioned above, there are other benzodiazepines in the market that are less popular for use for several probable reasons such as causing too many side effects, too hard to find, too expensive to buy, have caused adverse effects on patients, was not really well known to doctors and pharmacists, or were initially good for anxiety but found better for other conditions. They are Broamzepam as Lexotan or Lexomil; Clobazam as Frisium; Clorazepate as Tranxene or Gen-Xene; Halazepam as Paxipam; Ketazolam as Anxon; Medazepam as Nobrium; Nordazepam as Nordaz or Calmday; and Prazepam as Centrax.
Alprazolam, commonly known as Zanax or Xanax is also a benzodiazepine that was first indicated for anxiety but since it was found to be better suited for the treatment of depression, it was thus prescribed for such.
Anxiety is a condition affecting a lot of people. It may be comforting to know that in some way, it can be treated and keep them free from anxiety. Medications are not always a sure way of treatment but at least it can do something to alleviate it.
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