MAIN CHAPTERS (CONTENTS)
- Potency
- Speed of elimination
- Duration of effects
- Therapeutic actions of benzodiazepines
- Mechanisms of action
Table 1. Benzodiazepines and similar drugs
Table 2. Therapeutic actions of benzodiazepines
Fig. 1. Diagram of mechanism of action of the natural neurotransmitter GABA (gamma aminobutyric acid) and benzodiazepine on nerve cells (neurons) in the brain
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Adverse effects of benzodiazepines
- Oversedation
- Drug interactions
- Memory impairment
- Paradoxical stimulant effects
- Depression, emotional blunting
- Adverse effects in the elderly
- Adverse effects in pregnancy
- Tolerance
- Dependence
Socioeconomic costs of long-term benzodiazepine use
Table 3. Some socioeconomic costs of long-term benzodiazepine use
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Why should you come off benzodiazepines?
Before starting benzodiazepine withdrawal
- Consult your doctor and pharmacist
- Make sure you have adequate psychological support
- Get into the right frame of mind
- Dosage tapering
- Switching to a long-acting benzodiazepine
- Designing and following the withdrawal schedule
- Withdrawal in older people
- Withdrawal of antidepressants
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Schedule 02: Simple withdrawal from diazepam (Valium) 40mg daily
Schedule 03: Withdrawal from lorazepam (Ativan) 6mg daily with diazepam (Valium) substitution
Schedule 04: Withdrawal from nitrazepam (Mogadon) 10mg at night with diazepam (Valium) substitution
Schedule 06: Withdrawal from clonazepam (Klonopin) 3mg daily with substitution of diazepam (Valium)
Schedule 07: Withdrawal from alprazolam (Xanax) 4mg daily with diazepam (Valium) substitution
Schedule 08: Withdrawal from lorazepam (Ativan) 3mg daily with diazepam (Valium) substitution
Schedule 09: Withdrawal from temazepam (Restoril) 30mg nightly with diazepam (Valium) substitution
Schedule 11: Withdrawal from chlordiazepoxide (Librium) 25mg three times daily (75mg)
Schedule 12: Withdrawal from zopiclone (Zimovane) 15mg with diazepam (Valium) substitution
Schedule 13: Antidepressant Withdrawal Table
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Mechanisms of withdrawal reactions
Individual symptoms, their causes and how to deal with them
- Insomnia, nightmares, sleep disturbance
- Intrusive memories
- Panic attacks
- Generalised anxiety, panics and phobias
- Sensory hypersensitivity
- Depersonalisation, derealisation
- Hallucinations, illusions, perceptual distortions
- Depression, aggression, obsessions
- Muscle symptoms
- Bodily sensations
- Heart and lungs
- Problems with balance
- Digestive problems
- Immune system
- Endocrine problems
- Fits, convulsions
Extra medication during benzodiazepine withdrawal
Benzodiazepine use during and after withdrawal
Table 1. Benzodiazepine withdrawal symptoms
Table 2. Antidepressant withdrawal symptoms
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Protracted withdrawal symptoms
- Anxiety
- Depression
- Insomnia
- Sensory and motor disturbances
- Possible mechanisms of persisting sensory and motor symptoms
- Poor memory and cognition
- Do benzodiazepines cause structural brain damage?
- Gastrointestinal symptoms
- Coping with protracted symptoms
- How long do benzodiazepines stay in the body after withdrawal?
Table 3. Some protracted benzodiazepine withdrawal symptoms
Table 4. Some possible causes of protracted benzodiazepine withdrawal symptoms
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