Benzodiazepines • Effects, side effects & addiction

Author: Monika Preuk, medical writer
Last updated: November 08, 2021

At least one in ten people has already taken sedatives and sleeping pills. Benzodiazepines are highly effective drugs, but they are highly addictive. Effect, safe use, side effects and when the sedative and sleeping pills should not be used.

Benzodiazepines are among the most commonly prescribed sedatives (tranquilizers) and sleeping pills (hypnotics). Up to 1.6 million Germans are dependent on these prescription drugs. The best-known representative came onto the market as early as the 1950s: the active ingredient diazepam under the trade name Valium. In order to reduce the side effects of the highly effective substance and to reduce the risk of addiction, numerous other benzodiazepines have been developed to date.

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List of the most important benzodiazepines

The most common active substances among the benzodiazepines include:

  • Alprazolam
  • Bromazepam
  • Brotizolam
  • Chlordiazepoxid
  • Clobazam
  • Clonazepam
  • Diazepam
  • Dipotassium clorazepate
  • Flunitrazepam
  • Flurazepam
  • Lorazepam
  • Lormetazepam
  • Medazepam
  • Midazolam
  • Nitrazepam
  • Oxazepam
  • Prazepam
  • Temazepam
  • Triazolam

Benzodiazepines: Effects on the body and mind

Benzodiazepines are prescription psychotropic drugs, so they work through the brain on the psyche. Benzodiazepines influence the metabolism in the brain and the messenger substances (neurotransmitters). Docking sites (receptors) for benzodiazepines are not only found in the brain, but also in the spinal cord and many organs. Benzodiazepines thus act in the entire central nervous system.

They change the activity of the inhibitory neurotransmitter gamma-amino-butyric acid (Gaba). This in turn affects the hormones norepinephrine, Acetylcholine and serotonin. As a result, benzodiazepines work both physically and mentally. The physical effects of benzodiazepines are antispasmodic and muscle relaxant.

Psychological effects of benzodiazepines:

  • anxious
  • reassuring
  • sleep-inducing
  • mood-lifting to euphoric
  • anti-aggressive

Depending on the substance, one or the other effect is in the foreground. Accordingly, benzodiazepines are prescribed for the following diseases:

Benzodiazepines are also often given before surgery to reduce excitement.

Side effects and breakdown duration of benzodiazepines

Like any highly effective drug, benzodiazepines have a number of side effects. The most common are:

  • dizziness
  • headache
  • Loss of libido
  • Drowsiness
  • fatigue
  • Muscle weakness
  • Impairment of the reaction time: In order to avoid accidents, one should not drive a car or otherwise use machines and heavy equipment, especially at the beginning of the treatment.

Elderly people can also experience confusion and excitement as a side effect. In addition, the risk of falling increases in this age group when taking benzodiazepines.

It is also important to know that benzodiazepines have a very long half-life. This means that the drugs are broken down very slowly in the body. Depending on the active ingredient, the substance may only have completely disappeared from the organism after several days. If benzodiazepines are taken regularly, it can lead to an accumulation.

Benzodiazepines and Alcohol: Hazardous Mixture

Basically, the psychotropic drugs may only be used after consultation with a doctor. Benzodiazepines should also never be taken with alcohol, heroin or methadone. Alcohol and the aforementioned addictive substances increase the effect of the tablets. Life-threatening side effects such as respiratory paralysis can develop.

Contraindications: Who should not take benzodiazepines

As a general rule, benzodiazepines should not be taken during pregnancy, in the case of narrow-angle glaucoma (a special type of glaucoma) and in the case of previous alcohol, drug or medication abuse.

Benzodiazepines and Addiction: Dependence is common

A particularly dramatic side effect of long-term treatment with benzodiazepines is addiction. Drug addiction is not a problem for a fringe group, but affects more than a million people in Germany, mainly women. This figure is based on data from the prescription benzodiazepines. The number of unreported private prescriptions is not known.

Studies have shown that with benzodiazepines there is a risk of physical or psychological dependence after one to four weeks. Short-term use is useful for many diseases, such as an epilepsy attack or an anxiety disorder, but continuous use is dangerous. The effect of the tablets gradually weakens, and some people then take more and more of them. Other signs of benzodiazepine addiction include:

  • Change in personality
  • massive mood swings
  • Everyday tasks can hardly be mastered
  • Muscle weakness

Withdrawal symptoms when stopping benzodiazepines

But how should benzodiazepines be discontinued? If the intake is stopped from one day to the next, withdrawal symptoms occur on. This is possible even if the drug has only been used in small doses, but over a longer period of time. Withdrawal symptoms range from difficulty sleeping and tremors to nausea and panic attacks.

Benzodiazepines should therefore only be tapered off under medical supervision and strictly according to his instructions. This means that the dose is gradually reduced so that the body and mind get used to doing without the substance again.

“Benzos”, “Slides”, “Flunies”: Benzodiazepines as drugs

Benzodiazepines are also misused as drugs because of their anti-anxiety and relaxing effects. In scene jargon they are called “Benzos”, “Dias” or “Flunies” depending on the active ingredient. They are taken as high-dose tablets, their powder sniffed or dissolved and injected intravenously. Because of the high dose, it is easy to become addicted. In addition, benzodiazepines are also misused as knockout drops because of their relaxing effect.

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Source: Lifeline | Das Gesundheitsportal by

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