Benzodiazepines, including alprazolam (Xanax), temazepam (Nocturne), diazepam (Valium) and lorazepam (Ativan), treat symptoms associated with anxiety and seizure disorders. Like alcohol, the drugs work by augmenting the function of the brain chemical messenger GABA. Not surprisingly, side effects that occur after benzodiazepine use mirror those occurring with alcohol. Individuals may experience drowsiness or poor retention of information, and longer-term, physical--psychological dependence. A withdrawal syndrome can also emerge in outpatients abruptly discontinuing treatment.
Sedation and Nausea
People suffering from generalized anxiety disorder (GAD), post-traumatic stress or obsessive-compulsions benefit from the tranquilizing effects of benzodiazepines. However, when exaggerated, these effects may interfere with daily activities, causing vertigo and confusion or wholesale sedation. Drowsiness induced by benzodiazepines can impair motor coordination, making it more difficult to drive a car or disrupt concentration at work. Changes in visual acuity or slurred speech sometimes follow. According to the Center for Substance Abuse Research at the University of Maryland, individuals taking the drugs will also tend to experience general stomach unrest. They may feel nauseous, have discomfort digesting food, lose their appetite or develop constipation.
Cognitive Impairment
Patients suffering from seizures as a consequence of head injury or an epilepsy syndrome benefit from the anticonvulsant effects of benzodiazepines. Clonazepam (Klonopin) designates the benzodiazepine of choice for this indication. Seizures occur when the balance of excitation and inhibition in the brain tilts toward too much excitation. The ability of benzodiazepines to curtail seizure activity derives from their ability to amplify GABA, an inhibitory signal that decreases the rate at which neurons fire. However, neural circuits need to maintain a certain level of excitation (and excitatory bursting) to process and retrieve factual information. Sustained benzodiazepine use has the potential to reduce circuit excitability enough to interfere with universal forms of learning and memory.
Drug Dependence and Withdrawal
Individuals taking benzodiazepines for prolonged periods of time can develop psychological dependence on the drugs. Addiction occurs especially in people treated for insomnia or stress-related illness, and can occur in "innocuous" situations where elderly patients are provided chronic pain management or end-of-life-care. In a review article published in "Pharmacology, Biochemistry and Behavior," Drs. Licata and Rowlett of Harvard Medical School suggest that physical dependence underscores the psychological addiction. For instance, sudden cessation of benzodiazepine treatment can result in a withdrawal syndrome characterized by tremors, heightened anxiety and sleep disturbances. The severity of withdrawal correlates with the duration of benzodiazepine use and dosage: the longer the use and higher the dose, the more severe the symptoms.
References
- National Institute of Mental Health: What medications are used to treat anxiety disorders?
- New York University, Comprehensive Epilepsy Center: Clonazepam (Klonopin)
- Neuropsychopharmacology; Effects of Alprazolam on Driving Ability, Memory Functioning and Psychomotor Performance: A Randomized, Placebo-Controlled Study; J.C. Verster et al.; August 2002.
- University of Maryland, Center for Substance Abuse Research: Benzodiazepines
- Pharmacology, Biochemistry and Behavior; Abuse and Dependence Liability of Benzodiazepine-type Drugs: GABA(A) Receptor Modulation and Beyond; S.C. Licata and J.K. Rowlett; July 2008.
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