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Benzodiazepines, like many other sedative hypnotic drugs, cause apoptotic neuronal cell death. However, benzodiazepines do not cause as severe apoptosis to the developing brain as alcohol does. [105] [106] [107] The prenatal toxicity of benzodiazepines is most likely due to their effects on neurotransmitter systems, cell membranes and protein ...
Benzodiazepines typically start working very quickly — their anti-anxiety effects may come on in less than an hour. They work so well (short-term) that many people don’t want to stop taking them.
In terms of the mechanism of action of benzodiazepines, their similarities are too great to separate them into individual categories such as anxiolytic or hypnotic. For example, a hypnotic administered in low doses produces anxiety-relieving effects, whereas a benzodiazepine marketed as an anti-anxiety drug at higher doses induces sleep. [175]
Imovane – a non-benzodiazepine hypnotic; Inderal (propranolol) – a beta blocker; it is used for acute anxiety, panic attacks, and hypertension; Intuniv - an extended release, non-stimulant alpha-2 adrenergic agonist used to treat attention deficit hyperactivity disorder. Available in instant-release under the brand-name Tenex.
Withdrawal syndrome is a common drawback of benzodiazepines because of the development of a physical dependence on them after abrupt withdrawal. It is characterized by sleep disturbance, tremors, increased anxiety and tension, headache, muscular stiffness and pain, which may last 10–14 days. [13]
Benzodiazepines are effective in emergent and short-term treatment of anxiety disorders due to their fast onset but carry the risk of dependence. [4] Buspirone is indicated for GAD, which has much slower onset but with the advantage of less sedating and withdrawal effects.
Because benzodiazepines can be abused and lead to dependence, their use should be avoided in people in certain particularly high-risk groups. These groups include people with a history of alcohol or drug dependence, people significantly struggling with their mood or people with longstanding mental health difficulties.
Flurazepam is a "classical" benzodiazepine; some other classical benzodiazepines include diazepam, clonazepam, oxazepam, lorazepam, nitrazepam, bromazepam, and clorazepate. [16] Flurazepam generates an active metabolite, N-desalkylflurazepam, with a very long elimination half-life. [3]
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