Do you sometimes feel overwhelmed, anxious, or scared for no reason? Sometimes you can't sleep at night? Or do you get nervous before a major surgery? At times like these, your doctor may prescribe a small pill to help you calm down and sleep better. Benzodiazepines, which we're talking about today, are a type of medication that is given in this way. These are also called "benzos" for short.
Simply put, how does this medicine work?
Think of our nervous system as a busy road that is constantly working, carrying messages back and forth. When this road gets a little too fast, we feel things like anxiety and fear. Benzodiazepines work by sending a small signal to our brain, slowing down this nervous system a little, and calming it down.
To be precise, there are chemicals in our brain that carry messages, and we call them neurotransmitters. What these drugs do is tell the brain to release a special neurotransmitter called gamma-aminobutyric acid (GABA) . The main job of this messenger called GABA is to calm the nervous system. It's like telling the entire system, "Okay, let's work a little harder, let's relax."
When the nervous system is calmed in this way, we experience several key effects.
| Nature of the impact | Simply meaning |
|---|---|
| Amnestic (memory impairment) | This drug temporarily blocks the formation of new memories while it is taking effect. This is useful when administering anesthesia before surgery. |
| Anxiolytic (anxiety reducer) | This is done to "relax" things like fear, anxiety, and stress. It reduces the heaviness in your mind. |
| Hypnotic | The meaning of this word is related to sleep. These medications make you feel drowsy and help you sleep well. |
| Sedative | This "calms" the nervous system, creating a sense of calm and tranquility. It relaxes the muscles. |
What types of conditions are these medicines used for?
Benzodiazepines are not a single drug, but a class of drugs. Therefore, different types of drugs in this class are used for different medical conditions.
- Anxiety Disorders: These are very useful for conditions like social anxiety disorder and panic disorder.
- Insomnia: These are prescribed to help people who cannot sleep at night achieve short-term sleep.
- Epilepsy and Seizures: These are given as life-saving medications to control seizures, especially in cases of `Status Epilepticus`, a dangerous condition that persists.
- Muscle Spasms: These are used to relax painful, tense muscles in the body.
- Alcohol Withdrawal: These are given to control severe symptoms that occur when you suddenly stop drinking alcohol.
- Before surgery: These are given before surgery to calm the patient and help with anesthesia.
Some of the most common benzodiazepines in Sri Lanka are `Alprazolam` (Xanax®), `Diazepam` (Valium®), `Clonazepam` (Klonopin®), and `Lorazepam` (Ativan®). But more than knowing these names, it is important that your doctor prescribes the most appropriate medication for your condition.
What are the risks and disadvantages of using this medication?
Although benzodiazepines are a very useful class of medications, we need to be very careful when using them, as there are several risks associated with them.
The most important warning: Never drink alcohol while taking benzodiazepines for any reason. The combination of the two can cause dangerously low levels of nervous system activity, which can even lead to fatal consequences, such as respiratory arrest.
Other risks are:
1. Potential for Abuse and Dependence: When these medications are used for a long time, there is a high chance that the body will become accustomed to them, meaning that they will become addictive. Therefore, using these without the advice of a doctor or increasing the dosage is very dangerous.
2. Risk of Overdose: Overdose can occur and even cause breathing to stop, especially if taken with other medications that cause drowsiness or alcohol.
3. Drowsiness and decreased ability to react: Taking this medication can slow down your body's reflexes. Therefore, you should avoid doing things like driving, working at heights, and operating heavy machinery while taking it.
4. Risk of misuse: Some people use these drugs for criminal purposes. For example, someone can unknowingly mix them into a drink, rendering the person unconscious and subjecting them to abuse. The drug `(Flunitrazepam)`, also known as `Rohypnol`, has become notorious for this.
What do we need to do to use this medicine safely?
With all these risks, you must follow these guidelines to use benzodiazepines safely.
Follow exactly what the doctor says.
Take this medicine only in the dose, at the time, and for the duration prescribed by your doctor. Never increase the dose on your own just because you feel better, or tell a friend that this medicine is good. Also, if you need to stop taking the medicine, do so only after talking to your doctor. Stopping it suddenly can cause withdrawal symptoms.
Keep your medicine safe.
This is very important. Keep your medicines in a well-closed, locked place, especially out of reach of children and other people in the house. Often, people who misuse these medicines find them in the medicine cabinets of family and friends.
If you suspect an addiction, don't be afraid to speak up.
If you are concerned or have any concerns about becoming addicted to this medication, feel free to discuss it openly with your doctor. A doctor's job is not to judge you, but to help you. He or she can then reduce the dose, switch you to another medication, or change your treatment plan as appropriate.
How can you protect yourself from unknowingly ingesting this medicine?
Sometimes, without us knowing, someone might put a drug like this in one of our drinks. This can happen to anyone, regardless of gender. So be careful about this in a public place or at a party.
- Don't leave your drink alone. Don't let it out of sight, even for a second.
- Don't accept drinks from strangers. Sometimes, it's the people we think are our friends who do these things.
- Be careful when drinking from open punch bowls.
- If you have the slightest suspicion that your drink has been adulterated, do not drink it. If you suspect that something has happened to you, immediately seek help from someone you trust or go to a hospital.
In case of overdose or suspected poisoning, immediately take the patient to the nearest hospital Emergency Department (ETU) . Alternatively, you can call the National Poisons Information Centre at the Colombo National Hospital for advice.
Take-Home Message
- Benzodiazepines are a very useful and powerful class of medications used to treat conditions such as anxiety and insomnia.
- These should only be used under the recommendation and supervision of a qualified physician.
- Never give your prescribed medication to others. Also, do not use other people's medications.
- Avoid drinking alcohol for any reason while taking this medication.
- Keep your medicine locked in a safe place, out of the reach of children and others.
- If you have any concerns about addiction or any other side effects, don't be afraid to talk to your doctor.
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