Benzodiazepine
Overview
Benzodiazepines are a class of psychoactive drugs designed to treat a range of conditions, primarily anxiety and insomnia. They are among the most commonly prescribed medications in the world, particularly among older patients. They are also frequently used in the treatment of muscle spasms, seizures, alcohol withdrawal, and as a premedication for medical or dental procedures.
Pharmacology
Benzodiazepines work by increasing the efficiency of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. GABA is an inhibitory neurotransmitter which reduces the activity of neurons. Benzodiazepines enhance the effect of GABA, leading to sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties.
Medical Uses
Benzodiazepines are used for a variety of medical conditions. They are most commonly used for the short-term relief of acute symptoms of anxiety. In the case of insomnia, benzodiazepines are typically used only for short-term relief of acute symptoms. Long-term use of benzodiazepines for insomnia is not recommended due to the risk of dependence and other side effects.
Side Effects
Like all medications, benzodiazepines have potential side effects. These can include drowsiness, dizziness, decreased alertness and concentration, and impaired motor function. Some people may also experience paradoxical reactions such as worsening of seizures, aggression, impulsivity, and suicidal behavior. Long-term use can lead to tolerance, dependence, and withdrawal symptoms upon discontinuation.
Dependence and Withdrawal
Long-term use of benzodiazepines can lead to physical dependence. Symptoms of benzodiazepine withdrawal include anxiety, irritability, insomnia, and in severe cases, seizures. Withdrawal symptoms can be severe and are more likely with abrupt discontinuation. Therefore, if a person has been using benzodiazepines for a long period, it is important to reduce the dose gradually under medical supervision.
History
Benzodiazepines were first discovered in 1955 by chemist Leo Sternbach while working at the pharmaceutical company Hoffmann-La Roche. The first benzodiazepine, chlordiazepoxide (Librium), was synthesized in 1955 and marketed in 1960. It was followed by diazepam (Valium) in 1963.