Benzodiazepine class of drugs is used in a variety of health problem. That said, they are known to cause dependence, tolerance and withdrawal effects.

Benzodiazepine is a psychoactive medicine used to treat insomnia, anxiety, and a range of other conditions. These are one of the most commonly prescribed medications in the U.S., mainly among elderly patients. Current studies reveal that the use of benzodiazepine for prolonged periods to treat insomnia and anxiety increases the  risk of developing Alzheimer’s disease, a form of dementia. Now dementia is the main cause of dependency of older people affecting 36 million people worldwide. This figure is expected to be doubled every two decades.

What are the benzodiazepine and its uses?

Benzodiazepines are a group of drugs that work on the central nervous system(CNS).They act selectively on gamma-aminobutyric acid-A (GABA-A) receptors in the brain. They potentiate the effect of GABA, an inhibitory neurotransmitter hence preventing the neuronal excitation and gives calmness. Different benzodiazepine impart similar pharmacological actions but having different potencies, so they have multiple uses like as anticonvulsants, sedatives, hypnotics,  anxiolytics and muscle relaxants.

What are the different types of benzodiazepine?

Benzodiazepine may be classified on the basis of mode of action. The different types of benzodiazepines are as follow:

• Short-acting compounds: triazolam
• Medium-acting compounds: estazolam
• Long-acting compounds: diazepam, flurazepam

What are the benzodiazepine side effects?

Though benzodiazepine classes of drugs have a range of pharmacological actions and tend to be well tolerated, they have side effects too that you must know before taking it. The possible associated side effects of benzodiazepine are listed below:

• Benzodiazepine addiction

Despite its many uses, benzodiazepines can cause physical as well as psychological addiction. When benzodiazepines are administered in the regular manner for a long period, the body become accustomed to the presence of the drug and the person seeks the drug for normal physiological functioning. This is known as physical dependence. Tolerance and withdrawal are the signs of physical dependence. Aside of these signs the following are the signs and symptoms of benzodiazepine addiction.

• The person continues the use the medication even after knowing or suffering from ongoing or frequent physical or psychological problems.
• Intake of the larger amounts of drug than prescribed.
• Intake of drug for longer periods.
• The person loses the social interest and takes aside from social, work, recreational, or school activities.

• Benzodiazepine tolerance

Prolong use of benzodiazepine causes tolerance. The longer you take the drug greater the chances to develop the tolerance. Though the development of tolerance is a gradual process but may develop rapidly in within a few weeks.  In this condition the action of the drug does not come on usual dose and the body respond only for the extended dose.

• Benzodiazepine withdrawal

Commonly known as “Benzo withdrawal”, is a group of symptoms that come out when a person is taking benzodiazepine has developed dependence  and undergoes dose reduction or discontinuation of drug. The symptoms that emerges due to Benzo withdrawal are sleep disturbance, irritability, increased tension, anxiety, panic attacks, hand tremor, confusion and cognitive difficulty, sweating, difficulty with concentration, memory problems, muscular pain and stiffness, dry retching and nausea, weight loss, palpitations, headache, hallucinations. These withdrawal symptoms may last to few weeks to one year. The best solution to prevent the withdrawal effect is to taper off the dose in sensible rate. Though this unnecessary stretch in tapering may also develop the withdrawal effects.

•    Cognitive impairment

The current studies have made known the eye opening fact that prolong users of benzodiazepine are more prone to develop dementia. In last 15 years, dementia was diagnosed considerably more often in benzodiazepine users than in nonusers (32% vs. 23%)¹. Though causal relationship and pathophysiological relevance are not yet clear, but following facts can correlate benzodiazepine to dementia.

• Benzodiazepine may influence the neurotrophic signaling linked to intense down regulation of nerve growth factor-induced gene-A, BDNF, transcription factor GIF.
• Benzodiazepine alters the functional properties of GABA-A that resemble these GABA-A receptor subunit alteration observed in Alzheimer’s disease.
• Benzodiazepine may involve in down regulation of certain gene expression and protein level results in disturbed neuronal functioning.
• In some studies, benzodiazepines are found to cause mitochondrial dysfunction and that suppose to be source for the free radical initiating mental retardation that leads into dementia.

Another side effect at higher dose of benzodiazepine includes:

• Drowsiness
• Confusion
•  Dizziness
• Blurred vision
• Weakness
• Poor judgment and decision making
• Slurred speech
• Lack of coordination
• Difficulty breathing
• Coma
• Death from respiratory arrest

Benzodiazepine is now an effective treatment option for  so many diseases, but unnecessary long-term use of these drugs should be taken as a public health concern.Discuss with your physician routinely about what the changes you are facing in your daily life, if you are taking benzodiazepine.Take only prescribed dose up to the prescribed time.Be aware of the recurrent effects of medication to avoid the future consequences.