Benzodiazepine

The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsive, amnestic and myorelaxant properties. They are believed to act on receptors near the GABA receptor[?] which dampens neuronal activity.

Benzodiazepines are used in short term relief of severe, disabling anxiety but their prolonged use is discouraged because of tolerance and dependency.

Benzodiazepine withdrawal syndrome may be delayed (but less so with short-acting agents) in its onset and longer than barbiturate withdrawal syndrome. The benzodiazepine syndrome is characterized by:

• insomnia
• anxiety
• tremor
• perspiration
• loss of apetite
• delusions

As some of the symptoms of the syndrome are identical to the original reasons for the prescription of the drug it may encourage further prescribing. It must be remembered that benzodiazepines are the largest group of misused drugs. [1] (http://bmj.com/cgi/content/full/315/7103/297#Commonly_misused_drugs)

Every person on long-term or high dosage of any benzodiazepine should be weaned off the drug. Any abrupt discontinuation may result in confusion, psychosis, convulsions similar to delirium tremens.

Benzdiazepines may impair ability to drive vehicles and operate machinery.
This is increased by consumption of alcohol.
Long-acting benzodiazepine "hang-over" can cause the same problems the following day.

These drugs are preferred to the use of barbiturates because they have a lower abuse potential and relatively lower adverse reactions or interactions. However, drowsiness, ataxia, confusion, vertigo, impaired judgement and a number of other effects are common.

Benzodiazepines are divided into three groups for treatment of insomnia. Short-acting compounds act for less than six hours and have few residual effects, but rebound insomnia is common and anxiety levels may increase. Intermediate-acting compunds have an effect for 6-10 hours, may have mild residual effects but rebound insomnia is not common. Long-acting compunds have strong sedative[?] effects that persist and accumulation may occur.

Some examples of benzodiazepines:

• diazepam ("Valium")
• oxazepam[?] (a metabolite of diazepam)
• alprazolam[?]
• prazepam[?]
• bromazepam[?]
• clorazepate dipotassium[?]
• lorazepam
• temazepam
• medazepam[?]
• flunitrazepam
• clonazepam[?]

Benzodiazepines used to be widely prescribed medicines for stress-related ailments in the 1960s and 1970s.
Diazepam under the proprietary name - Valium, was one of the best selling medicinal products.