Benzodiazepines are a group of medications which have been used since the 1960s to treat:
anxiety
epileptic seizures
mania
alcohol withdrawal
sleeping problems.
They replaced the barbiturates which had been commonly prescribed for 50 years around the 1950s, but which were addictive and very dangerous in overdose.
They include:
Temazepam (Normison)
Nitrazepam (Mogadon)
Diazepam (Valium)
Lorazepam (Ativan)
Chloriazepoxide (Librium)
Those that have a short effect have been marketed as sleeping tablets – the idea being that you don't get a ‘muzzy’ head the next day. Others with a longer effect have been marketed for their use in controlling anxiety. They all have similar side effects and withdrawal symptoms.
There has also been a big increase in the prescribing of the newer non-benzodiazepine sleeping pills such as:
Zopiclone
Zolpidem
Zaleplon
These newer drugs can cause side-effects and withdrawal symptoms that are every bit as bad as those caused by the benzodiazepines.
They all work in a similar way by boosting the effect of a substance in the brain – GABA (a neurotransmitter) – a chemical which is used in the brain to control the passage of impulses from one cell to another. GABA has a generally calming effect in the human brain.
Some side effects of taking these medications are:
Sleepiness
Unsteadiness
Memory problems
Benzodiazepines are potentially addictive drugs. Psychological and physical dependence can develop within a few weeks or months of regular or repeated use. The British National Formulary (BNF) recommend that these medications should be prescribed for 2-4 weeks only. Their side effects and withdrawal symptoms can lead to breakdown and temporary mental illness. Effects of medium and long-term benzodiazepine use include agoraphobia, panic attacks, anxiety, confusion, poor quality of life and physical health. Abrupt or too rapid withdrawal can result in major convulsions which can be life threatening. Other severe withdrawal effects include acute psychotic reactions and hallucinations, delusions, paranoia and acute confusional states. Major depressive disorders and even suicide attempts may follow withdrawal after an interval. Recovery after complete withdrawal from benzodiazepines may take months or even years to complete.
How many people are taking them?
In 2018, community pharmacists in England issued 70.9 million prescriptions for antidepressants. It has been estimated that there are around 2 million chronic users in England and Wales (i.e. people taking the drugs for 4 months or more). There has been a 29% increase in prescriptions for diazepam alone over 12 years.
What is the official line?
The Committee on Safety of Medicines issued advice to all prescribing doctors in 1988, stating that benzodiazepines were indicated only in the very short-term (2-4 weeks) and only for disabling anxiety and insomnia. Despite this, some doctors are still prescribing benzodiazepines to new patients for indefinite periods. Nationally, little has been done to reduce the huge numbers of people addicted, although particular efforts have been made in some areas (e.g. Bristol).
