Benzodiazepines
Benzodiazepines – a list of drugs and their effects. What to do in case of poisoning and intoxication? What is the most effective antidote? We will talk about the narcotic effect of benzodiazepines, as well as analyze the mechanism of action of the drugs.
This is the name of a group of psychotropic drugs that have sedative, sedative, hypnotic and anticonvulsant effects. By acting on GABA receptors, they suppress the excitability of the nervous system and are prescribed for the treatment of epilepsy, panic attacks, relieve anxiety, muscle spasms, and are used to treat insomnia, but when used improperly, benzodiazepines turn into dangerous addictive drugs.
The effect of benzodiazepines
Once in the body, drugs of this type come into contact with GABA receptors, changing the flow of chlorine ions into the cells of the central nervous system, which causes an inhibition of activity. At the same time, each type of medication is designed to affect subclasses of receptors responsible for certain reactions. Thus, by acting on the alpha receptors of benzodiazepines, the drug reduces anxiety, increases drowsiness on others, and suppresses muscle cramps and nervous tics on others.
This group of receptors regulates appetite, eating, and emotional behavior, reduces anxiety, and prevents seizures and tics during temperature changes. If their work is disrupted, a person’s eating behavior changes regardless of the feeling of hunger (the so-called nervous overeating, which provokes the development of obesity, cravings for sweets, develops anxiety, panic attacks, convulsive syndrome, and much more.
Benzodiazepine receptors can be affected by only 2 substances — benzodiazepines and ethyl alcohol. That’s why drinking alcohol can change your appetite and cause you to feel relaxed and anxious. The mechanism of action of benzodiazepines is similar to that of ethanol, causing symptoms such as lethargy, impaired coordination, speech, decreased anxiety, and panic. The intoxicating effect is achieved when the dosage recommended by a specialist is exceeded. Just as with alcohol, people who abuse benzodiazepines and take them without a doctor’s prescription for intoxication feel a sense of euphoria, intoxication, which is dulled by regular use. e
Among people who have become addicted to benzodiazepines, there are many elderly people who consider the therapeutic dosage prescribed by a doctor insufficient and self-prescribe the dosage. Many of them like the fact that drugs of this group bring muscle and vascular tone back to normal, but this is a dangerous idea, since overdose and intoxication can occur, and a pronounced hypnotic effect can provoke accidents, for example, when driving a car.
The effect of drugs that are not used as prescribed by a doctor depends on the dosage, which subgroups of receptors are affected, and the frequency of use of the drug.
Side effects of benzodiazepines
This group of drugs is dangerous for heroin, opioid addicts, barbiturists, people suffering from bronchitis, short-term respiratory arrest during sleep, and depressed patients, especially those with suicidal tendencies. It is strictly not recommended to use benzodiazepines for pregnant women and nursing mothers.
The main symptoms of side effects:
Movement coordination disorders;
Fatigue and weakness;
Drowsiness without being able to sleep;
Impaired concentration and memory;
Tremor, trembling of limbs;
Big weight gain;
Confusion of consciousness;
Nausea, vomiting;
Skin rashes.
In depressive personality disorders, benzodiazepines increase suicidal tendencies. The drugs are not recommended for people suffering from excess weight and decreased attention, memory, asthenia, senile dementia and lowering blood pressure.
Achieving the narcotic effect of benzodiazepines
The effect of euphoria is achieved by exceeding the dosage recommended by the doctor and reducing the frequency of use. The drug tends to accumulate in the tissues, causing a pleasant feeling of relaxation, calmness, intoxication. In addition to sedative and hypnotic effects, benzodiazepine normalizes vascular tone, which makes it possible to normalize blood pressure, especially in the elderly, those who suffer from blood pressure fluctuations, cardiac arrhythmias, however, at a dosage exceeding the norm, this leads to rapid deterioration of the cardiovascular system, deterioration of well-being and possible death.
The first benzodiazepine appeared on the market in 1955, but later the FDA did not recommend using them for long-term use due to the occurrence of dependence and side effects.
Benzodiazepines: medications, list of medications
Such drugs include tranquilizers, anticonvulsants, sedatives, and sleeping pills. They differ in the strength of their effects and the duration of their half-life and elimination from the body. Here’s how the types of drugs containing benzodiazepine differ.:
Short—acting drugs for insomnia remain in the body for 1-12 hours, after which the sleep disorder may resume.;
The average effect is from 12 to 40 hours, causing a long—lasting hypnotic effect. They are used as tranquilizers, against insomnia, aggressiveness, overexcitation.;
Strong and long—acting drugs remain in the body for 40 to 250 hours. They are prescribed in extreme cases, for the treatment of severe patients with epilepsy, convulsive syndrome and other diseases.
Drugs of this group accumulate in the blood plasma and in the adipose tissue of the body. They remain in the urine for 24 hours to several weeks. The duration of benzodiazepines in the body depends on age, metabolic rate, dosage, duration of action and frequency of drug use.
The metabolism of benzodiazepines occurs in the liver, and the active substances themselves are excreted in the urine through the kidneys, so in people with diseases of these organs, the metabolites remain in the body for 100 hours or more, depending on the dosage. They are detected by a laboratory blood and urine test performed within a day after the last dose.
Benzodiazepines are available in the form of capsules, tablets, ampoules for intramuscular, subcutaneous and intravenous use. Here is a list of the main drugs.
Long-acting anticonvulsant medications:
Diazepam;
Lorazepam;
Klobazam;
Gidazepam;
Clonazipam;
Midazolam;
Chlorazapate and their analogues.
These drugs can only be taken according to a specialist’s prescription and strictly in the dosage indicated by the doctor, uncontrolled intake of these drugs can lead to severe intoxication, up to a fatal outcome. This group of drugs has the strongest and longest-lasting effect compared to other analogues of the group. The metabolites can remain in the body for up to 1-2 weeks.
Tranquilizers and benzodiazepines with anxiolytic effects that reduce anxiety include the following medications:
Phenazepam;
Bromazepam;
Chlordiazepoxide;
Alprazolam;
Medazipam;
Oxalepam and their analogues.
The above drugs should also be used only according to a doctor’s prescription and strictly in the specified dosage. Exceeding the dosage can lead to intoxication and the development of dependence.
The following fast-acting benzodiazepines have a mild hypnotic effect:
Temazipam;
Lormetrazipam;
Nitrazepam;
Flunitrazipam and their analogues.
The market for such drugs is constantly replenished, including derivatives of benzodiazepines. These include:
Olanzapine;
Egolanza;
Closed;
Azaleptin.
Despite the apparent simplicity of the effects and the availability of sleeping pills, you also need to be careful with them. Side effects of drugs can reduce the quality of life, and uncontrolled intake with excessive dosage contributes to the development of addiction.
Most of these medium- and long-acting drugs are available by prescription, but drug addicts manage to get them from pharmacies that sell them illegally. An increased dosage of even light sleeping pills causes dependence for 3-4 weeks.
How is dependence on benzodiazepines formed?
If the drugs are used in the dosage recommended by the doctor, the narcotic effect is extremely rare and is associated with the individual characteristics of the body. Two categories of citizens fall into the risk group — law-abiding pensioners and those who seek special effects from the use of medications.
When the dosage is exceeded, a person feels euphoria, lightness, relaxation, and serenity, but after 3-4 weeks of regular use, tolerance arises. The old euphoria cannot be achieved, and withdrawal symptoms appear. Dependence on this group of drugs changes a person’s character, mental and physical health.
Methods of non-medical use of benzodiazepines by drug addicts
Most benzodiazepines are available in the form of capsules, tablets, ampoules for intravenous, intramuscular and subcutaneous use. Amphetamine addicts use them to suppress seizures and relieve withdrawal symptoms, while other drug addicts use benzodiazepines to make narcotic cocktails.
Benzodiazepines are extremely dangerous to mix with alcohol and drugs, but drug addicts resort to this method in search of new sensations. Similar mixtures are also used for intravenous administration, contributing to the direct penetration of dangerous toxins into the blood. It is impossible to predict how a party with such cocktails will end, as well as to calculate the dosage. Such experiments result not only in severe poisoning, overdoses, including fatal ones, but also in polydrug addiction — dependence on several surfactants, which is very difficult to treat. It is extremely dangerous to combine them with opioid drugs, barbiturates.
Signs of dependence on benzodiazepines
They appear after a systematic intake of drugs for more than 2 weeks. In overweight people with slow metabolism, impaired liver and kidney function, addiction occurs within a week after systematic overdoses. The main signs of abuse:
Signs of alcohol intoxication without the smell of alcohol;
Relaxation, calmness, and serenity are unusual for a person in a normal state.;
Drowsiness, lethargy, lethargy;
Decreased concentration of attention;
Slow motion and speech;
Relief of pain sensitivity.
In case of one-time abuse, a person falls asleep within an hour after drug intoxication. If you wake him up at this time, the reaction will be aggressive, very fast and unpleasant for others.
With prolonged use, the following symptoms are added to the above-described signs:
Severe headaches:
Nightmarish dreams;
Hypotension;
Visual disturbances;
Loss of orientation in time and space.
Benzodiazepine abusers remain lethargic and drowsy for a long time, which provokes accidents, injuries on the road, and inattention to traffic regulations. People who are prone to depression experience suicidal thoughts, which can lead to unpredictable and dangerous consequences. Dependence can also occur when taking small doses, if they are taken regularly.
Benzodiazepine withdrawal syndrome is manifested by the following symptoms:
Sudden outbursts of aggression, arousal, and mood swings;
Anger, irritation;
The feeling of alienation of one’s own personality;
Bouts of anxiety, anxiety, and panic;
Nightmarish dreams, daytime illusions, confused consciousness;
A combination of lethargy, delayed reaction with overexcitation;
Depression, depression, increasing indifference.
Physiological symptoms of withdrawal:
Severe sweating;
Fingertip trembling;
Increase in body temperature;
Slowing of heart rate and respiration;
Pallor of the skin;
Pupil dilation.
The abuse of tranquilizers, anticonvulsants and hypnotics provokes an exacerbation and the appearance of mental disorders, emotional instability, which leads to unpredictable reactions of the body. Some patients develop psychoses, delusions, and hallucinations accompanied by a strong sense of fear.
Poisoning and intoxication with benzodiazepines
The abuse of tranquilizers, anticonvulsants and sleeping pills leads to poisoning. The excipients may be toxic to the body, which, combined with central nervous system depression, enhances the toxic properties of the drug. Poisoning often occurs with repeated overdose or the use of narcotic cocktails. In the latter case, it is very difficult to determine intoxication by symptoms, since it depends on an auxiliary substance — alcohol, cocaine or other drugs.
Benzodiazepine poisoning is more severe than from other drugs, as it is more difficult for the body to remove toxins from tissues. Outwardly, it resembles intoxication with opiates, barbiturates and other drugs that suppress the reaction of the nervous system.
Symptoms of poisoning:
Severe drowsiness, including confusion and loss of consciousness;
Difficulty breathing;
Pallor and coldness of the skin, cold sweat;
Nausea, vomiting;
Tachycardia;
Slurred speech;
Coordination disorders, drunken gait.
If such symptoms occur, you should immediately call an ambulance and, if possible, show the doctor the pills and medications you have taken. Before the arrival of specialists, the patient should absolutely not be given any pills. You can stimulate vomiting, wipe the patient’s mouth, lay him on his side, cover him with a towel or a blanket to keep him warm. It is important not to let him lose consciousness or fall into a coma.
The antidote to benzodiazepines
During medical care, doctors detoxify the patient and administer an antidote. Such a drug is Flumazenil, it is administered intravenously at a dosage of 0.1 — 2.5 mg, depending on the weight of the patient and the severity of poisoning. In severe cases, the injection is given at regular intervals. After the injection, the patient regains consciousness in 10-20 minutes. Detoxification is carried out in a medical facility, which allows you to quickly remove toxic substances from the body. Depending on the severity of the poisoning, treatment can take from a day to several days.
Effects of benzodiazepine abuse
The most severe of these is respiratory arrest, which can occur after an overdose or poisoning with the drug anywhere where the patient is located. The prolonged effect of depressive drugs on the central nervous system provokes chronic depression, decreased blood vessel tone, and the appearance and exacerbation of mental illnesses.
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