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Valerie J Stevens

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Prof. C H Ashton DM FRCP

Tranquillisers and Sleeping Pills

THE MOST COMMONLY prescribed minor tranquillisers and sleeping pills are as follows (the brand name is in brackets):

BENZODIAZEPINE MINOR TRANQUILLISERS

DIAZEPAM (VALIUM)
LORAZEPAM (ATIVAN)
CHLORDIAZEPOXIDE (LIBRIUM)
OXAZEPAM (OXAZEPAM)
ALPRAZOLAM (XANAX)

BENZODIAZEPINE SLEEPING PILLS
NITRAZEPAM (MOGADON)
TEMAZEPAM (TEMAZEPAM)
CLONAZEPAM (RIVOTRIL)

NON-BENZODIAZEPINE SLEEPING PILLS
ZOPLICLONE (ZIMOVANE)
ZOLPIDEM (STILNOCOT)
ZALEPLON (SONATA)

There has been a big increase over the past 10 years in the prescribing of the newer non-benzodiazepine sleeping pills.� The newer drugs can cause side effects and withdrawal symptoms that are every bit as bad as those caused by the benzodiazepines.

WHAT EFFECT DO THEY HAVE?

They can be effective drugs in the short term (2-4 weeks).� However, they can also be highly addictive 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, depression, 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 confusion states.

Major depressive disorders and even suicide attempts may follow too abrupt 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 2007 community pharmacists dispensed nearly 11.5 million prescriptions for benzodiazepines.� It has been estimated that there are around 1 million chronic users in England and Wales (i.e. people taking the drugs for 4 moths or more).

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).

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