Are the dangers of Benzodiazepines exaggerated in your opinion?

[TheUltimateFixx]

The main risk with them is withdrawal, as this can involve seizures and be fatal.

 

[Cream Gravy?]

I'm of the opinion that their 'dangers' are greatly exaggerated. I am scripted one daily off label though. I might be biased but I'm amazed at how rapidly I can reduce usage based upon need. I have no severe WDs assuming I don't CT.

 

[Skorpio]

I'll bet all of these new medications, like Trintellix, Belasomra, Dayvigo, Vybriid etc. will prove to carry many of the same problems as their predecessors;

Trintellix and vybriid are ssris/snris with fancy marketing (ok, they also have 5ht1a partial agonism, so like ssris with buspar mixed in). These are going to have similar side effects and withdrawals to related drugs.

Belasomra and dayvigo are orexin receptor antagonists. Frankly, I am less familiar with these, but they seem to be more analogous to a stronger melatonin than something benzo like or anti-histamine like. I have not heard of discontinuation symptoms yet.

Benzos have both really scared me, and not hit my pharmaceutical sweet tooth, so I have never gotten into long term habitual use with them. My main pattern of use would be getting a dozen or so from somebody who doesn't want them (it pays to be the responsible drug using friend to straight edge people with high strung dogs who apparently become even more high strung on xanax), and eating that supply in small quantities over a couple of months (which honestly by the end of it begins to worry me about developing a habit). I have done this once every couple of years, and it doesn't really bother me, although I do put in effort to not make connections with steady benzo folk.

I have seen benzos wreak more havoc on my drug using friends than any other class of drug. I have seen a few people become deviant idiots, crashing cars, and getting into horrible debts to some rather unsavory people while strung out, and then being anxious with PAWS for many months afterword.

I think SSRIs and their ilk will be preferred to benzos for prescription purposes for the foreseeable future, because they are not fun. Nobody has a stressful day and pops a few extra prozac to unwind. Benzos are currently getting demonized because we went through a period of overprescription, where people were dying from opioid-benzo ODs or just copping large habits and saying "but I didn't know". This kind of thing changes how drugs are prescribed.

 

[Cream Gravy?]

I have seen benzos wreak more havoc on my drug using friends than any other class of drug. I have seen a few people become deviant idiots, crashing cars, and getting into horrible debts to some rather unsavory people while strung out, and then being anxious with PAWS for many months afterword.

QFT though. I don't know what it is about benzos but it makes so many people into kleptomaniac assholes who forget they've done things.

 

[emkee_reinvented]

I agree that Benzos have been demonised here in Australia. Many GPs won’t prescribe them at all.

I have had long running issues with sleep and was put on Gabapentin for limb movement/RLS that was affecting sleep quality. During pregnancy, I wasn’t allowed gabapentin, so it was switched to 0.5 mg Clonazepam (klonopin) which is deemed safer in this situation. I also found my sleep quality improved and I had no daytime drowsiness on this dose of clonazepam (unlike gabapentin). Unfortunately after having kids, my Dr wanted me off the clonazepam and back on gabapentin (which has more side effects imo). I’ve had to fight tooth and nail to be prescribed it, now it’s prescribed at a lower dose, which is not as effective. I wish doctors would not mess with something that works, purely because of their principles. I stayed on 0.5 mg clonzepam safely for 5 years, no dose increase….why change?

I keep seeing ADs and anti seizure meds being prescribed for sleep or anxiety…the likes of Zoloft (which I’ve been on) are the very devil to get off and the side effects are brutal. They are nowhere near as effective as benzos for sleep or panic disorders.

Same over here. For severe sleeping problems I received 10 tabs of Midazolam, a worthless sleep med as it acts to short. And Quatiapine, a sedating sledgehammer type of anti-psychotic. Which also was worthless as sleep med gave the rest away.

Mt prescription for Clobazam for my Epilepsy and RC benzo's do a better job. But I am very curious about Zolpidem and sleep. Seems like the perfect candidate.

 

[Jabberwocky]

Same over here. For severe sleeping problems I received 10 tabs of Midazolam, a worthless sleep med as it acts to short. And Quatiapine, a sedating sledgehammer type of anti-psychotic. Which also was worthless as sleep med gave the rest away.

Mt prescription for Clobazam for my Epilepsy and RC benzo's do a better job. But I am very curious about Zolpidem and sleep. Seems like the perfect candidate.

If you were dissatisfied with midazolam then zolpidem will be even less useful. With regards how it affects you it is very comparable with midazolam - short acting hypnotic that will have you wide awake in 2 hours. It is great for sleep induction (if tolerance allows it) but not for maintaining sleep. Maybe if taken as a combo, like 10mg "zolpidem + 1mg lorazepam"...or some other drug that is good for keeping you asleep once sleeping. Just my experience.

And it is a weird substance with many possibly dangerous sideffects but also a molecule that can bring back people from coma (Hamilton's pharmacopeia - Zolpidem).

Best of luck snd take care!

 

[alyssa114]

The question is, if Benzos or Z drugs are not suitable for long term use for sleep disorders….what is? I’m not talking about the odd sleepless night, I mean going weeks and months without a decent sleep - trying to work, study and parent on little to no sleep (which is dangerous and also bad for health).

As someone else pointed out to me, sleep hygiene is for people without big sleep issues. Far more needs to be done if you have sleep disorders. I can do all of the sleep hygiene, even restrict sleep and still stay awake all night.

 

[alyssa114]

Same over here. For severe sleeping problems I received 10 tabs of Midazolam, a worthless sleep med as it acts to short. And Quatiapine, a sedating sledgehammer type of anti-psychotic. Which also was worthless as sleep med gave the rest away.

Mt prescription for Clobazam for my Epilepsy and RC benzo's do a better job. But I am very curious about Zolpidem and sleep. Seems like the perfect candidate.

I was on zolpidem for quite a while. Yes, it induced sleep. But not good sleep. It was quite a weird drug as it sometimes made me hallucinate and make my bedside light appear to go all different colours :D. But the next day, I felt crap. Headachey and nauseated in morning.

Zopiclone was a bit better. Alas, the source I got it from no longer exists, I didn’t have a legal script.

Klonopin drifts me off nicely and no headache the next day. I haven’t been on it for the past 2 months though. Will get a new script next month.

 

[Nas47]

I have use benzos from nearly ten uear.anxietybdisorder.but xanax don't fit me.it is valium.stable low dose.ain_t got issues with memory,nor coordination..feel normal.quitted one time -relatively easy.vut got my dose and it's addiction for sure

 

[emkee_reinvented]

I was on zolpidem for quite a while. Yes, it induced sleep. But not good sleep. It was quite a weird drug as it sometimes made me hallucinate and make my bedside light appear to go all different colours :D. But the next day, I felt crap. Headachey and nauseated in morning.

Zopiclone was a bit better. Alas, the source I got it from no longer exists, I didn’t have a legal script.

Klonopin drifts me off nicely and no headache the next day. I haven’t been on it for the past 2 months though. Will get a new script next month.

The taste of Zopiclone put me of, but afa sleep agents go it was doing the job very well.
Zolpidem's hallucination's intrigue so its my dope fiend that is most interested in it. But the after effects don't seem so forgiving according to your experience.

Over here Clobazam and Clonazepam are the only benzo's that are considered essential as they prevent Tonic-Clonic seizures. And because they are essential they are cost free, they fall under anti-epileptics. For the BZD's you really need a friendly doc or else they will cost you a lot of money. They have the ability to prescribe as necessity and only then the insurance covers them.

Never had a dr. do that, despite a year of no/ poor sleep. So RC's and off label use it is. Stopping drinking I'll admit also had a positive effect on my sleep architecture.

 

[Fertile]

Interesting that someone has mentioned clobazem. It's unique in being a 1,5-benzodiazepine and thus acting at different sites at the GABA receptor (compared to all the others which are 1,4-benzodiazepines). It's unusual in having a ceiling dose of about 40mg/day NOT for safety reasons, but because more doesn't do more. It will not stop a 1,4-benzodiazepine rattle directly, but it has similar properties so does help a little.

I can honestly see it becoming a treatment for anxiety because it isn't really recreational and it isn't possible to reach a HUGE level of dependence since their is a ceiling.

Only a couple of researchers have done further work on 1,5-benzodiazepines. I am prepared to bet it's because it's synthetically more complex to produce. I'm sure people will point to it being 4 steps, so not THAT complex, but it doesn't scale as well and the workup is more complex. Diazepam sells for $103/Kg in bulk, clobazam sells for $1300/Kg. That's twice as much as alprazolam.

I might add that the Ashton Manual doesn't recognize that clobazam cannot substitute for other benzodiazepines. I even contacted Dr. Aston and she was REALLY unhappy to be told. I was very careful to show due respect and explain that the difference may not have been known at the time she wrote the manual.... but no. Academics have a really fragile ego. I mean, I provided a lot of reference and she never said I was wrong, but she was downright nasty.

 

[emkee_reinvented]

Interesting that someone has mentioned clobazem. It's unique in being a 1,5-benzodiazepine and thus acting at different sites at the GABA receptor (compared to all the others which are 1,4-benzodiazepines). It's unusual in having a ceiling dose of about 40mg/day NOT for safety reasons, but because more doesn't do more. It will not stop a 1,4-benzodiazepine rattle directly, but it has similar properties so does help a little.

I can honestly see it becoming a treatment for anxiety because it isn't really recreational and it isn't possible to reach a HUGE level of dependence since their is a ceiling.

Only a couple of researchers have done further work on 1,5-benzodiazepines. I am prepared to bet it's because it's synthetically more complex to produce. I'm sure people will point to it being 4 steps, so not THAT complex, but it doesn't scale as well and the workup is more complex. Diazepam sells for $103/Kg in bulk, clobazam sells for $1300/Kg. That's twice as much as alprazolam.

I might add that the Ashton Manual doesn't recognize that clobazam cannot substitute for other benzodiazepines. I even contacted Dr. Aston and she was REALLY unhappy to be told. I was very careful to show due respect and explain that the difference may not have been known at the time she wrote the manual.... but no. Academics have a really fragile ego. I mean, I provided a lot of reference and she never said I was wrong, but she was downright nasty.

Clobazam and Pyrazolam are the only two benzo's that fall outside the regular.
Clobazam at the dosages you mentioned feels very good. Not prominent but its there, same goes for Pyrazolam.

 

[emkee_reinvented]

Interesting that someone has mentioned clobazem. It's unique in being a 1,5-benzodiazepine and thus acting at different sites at the GABA receptor (compared to all the others which are 1,4-benzodiazepines). It's unusual in having a ceiling dose of about 40mg/day NOT for safety reasons, but because more doesn't do more. It will not stop a 1,4-benzodiazepine rattle directly, but it has similar properties so does help a little.

To bad Zolpidem is portrait as useless as Midazolam, by its duration. On paper it seems at least a improvement. Its more the side-effects I am still interested in atm.

But as some one prescribed CLOBAZAM I should chime in. Of course the fact I know the dosage corresponds to the reality, something RC's lack. But its an really nice Benzo. Multipurpose, till 20 mg its functional. But at sleapy time in combo with 1/ 2 a dose of an hypnotic RC Benzo goes very well to.

My guess is at 40 mg Clobazam will become quite an nice one. Maybe akin to Pyrazolam. Also have that in my possession. And 20 mg Clobazam I rade higher then 3 mg Pyrazolam. But they do share some profile.

 

[Fertile]

Midazolam has a place in medicine but due to it causing rare but severe psychiatric side effects, it's best left to be used where medically trained people are there to observe. Generally speaking, fast onset and short duration is supposed to make a benzodiazepine more 'addictive'. I added the inverted comma because I think people here will know the difference between addiction and dependence.

Z-drugs seem to cause similar psychiatric side-effects. A lot of 'air rage' incidences are connected to their use. I have no way of knowing if Z-drugs were the true reason, but a brief search shows that the automatism clause of mental status (meaning someone does (did?) not possess mens rea (guilty mind)) has been used successfully as a criminal defence. In fact law books specifically mention zopiclone.

I suspect that clobazam has an ceiling on it's effects when the dose results in almost 100% receptor occupancy. Researchers have shown that much of the QSAR regarding 1,5-benzodiazepines mirrors that of 1,4-benzodiazepines. The 7-nitro homologue reached human trials but it was no more effective and caused more sedation. In hopes of reducing this problem, several prodrugs of the 7-nitro homologue were also produced, but no advantage was seen,

A triazolo or imidazo ring can be added with similar increases in potency. The pendant benzene ring can be '2 substituted and other 6-membered aromatics can replace the benzene.

I'm wary of nitrobenzodiazepines because they are a lot more toxic than other benzodiazepines in overdose and because people will lose track of how many they have taken... and overdose. While I am aware that temazepam got a bad name, it really wouldn't be hard to produce a formulation that could only be swallowed. I say that based on the UK experience of people injecting the liquid-filled capsules that went to feed the needle. I'm told IV benzodiazepines are a totally different experience, more like barbiturates.

That reminds me, has anyone else come across clomethiazole/chlormethiazole (Heminevrin/Nevrin™)? Of incredible value in treating severe alcohol dependence BUT should really only be given in an in-patient setting. Amazingly it appears to have remained legal. It's very dangerous in overdose and 5-6 capsules has killed; a lot considered it was never prescribed frequently. I learnt of a guy in his 70s that the UK nickname for them was 'duckeggs'. He lived through the barbiturate epidemic of the 1970s.

 

[emkee_reinvented]

Midazolam has a place in medicine but due to it causing rare but severe psychiatric side effects, it's best left to be used where medically trained people are there to observe. Generally speaking, fast onset and short duration is supposed to make a benzodiazepine more 'addictive'. I added the inverted comma because I think people here will know the difference between addiction and dependence.

Z-drugs seem to cause similar psychiatric side-effects. A lot of 'air rage' incidences are connected to their use. I have no way of knowing if Z-drugs were the true reason, but a brief search shows that the automatism clause of mental status (meaning someone does (did?) not possess mens rea (guilty mind)) has been used successfully as a criminal defence. In fact law books specifically mention zopiclone.

I suspect that clobazam has an ceiling on it's effects when the dose results in almost 100% receptor occupancy. Researchers have shown that much of the QSAR regarding 1,5-benzodiazepines mirrors that of 1,4-benzodiazepines. The 7-nitro homologue reached human trials but it was no more effective and caused more sedation. In hopes of reducing this problem, several prodrugs of the 7-nitro homologue were also produced, but no advantage was seen,

A triazolo or imidazo ring can be added with similar increases in potency. The pendant benzene ring can be '2 substituted and other 6-membered aromatics can replace the benzene.

I'm wary of nitrobenzodiazepines because they are a lot more toxic than other benzodiazepines in overdose and because people will lose track of how many they have taken... and overdose. While I am aware that temazepam got a bad name, it really wouldn't be hard to produce a formulation that could only be swallowed. I say that based on the UK experience of people injecting the liquid-filled capsules that went to feed the needle. I'm told IV benzodiazepines are a totally different experience, more like barbiturates.

That reminds me, has anyone else come across clomethiazole/chlormethiazole (Heminevrin/Nevrin™)? Of incredible value in treating severe alcohol dependence BUT should really only be given in an in-patient setting. Amazingly it appears to have remained legal. It's very dangerous in overdose and 5-6 capsules has killed; a lot considered it was never prescribed frequently. I learnt of a guy in his 70s that the UK nickname for them was 'duckeggs'. He lived through the barbiturate epidemic of the 1970s.

Thank's for that piece of info upon Midazolam.

Clomethiazole has been removed from the Farmacotherapheutisch Kompas long ago. Midadolam is shit imo.

 

[Fertile]

Clomethiazole is still out there. Maybe not every nation uses it, but no nation explicitly controls it. I'm certainly not recommending it - it's so very dangerous in overdose BUT I've seen it used to treat alcohol dependence and it has some unique benefits. Of course, I've also heard that it was so overused at one point that their were in-patient wards for people dependent on the stuff. Much like barbiturates (again).

It's interesting that clobazam seems to be used by more and more nations each year. I don't know why after 50 years it would still be of interest. I SUSPECT it's because the alternative, clonazepam, isn't well tolerated by many people and is often used in intentional overdoses (suicides). As you may know, people have survived multiple grams of diazepam (I've read of a case in which someone took 4 grams orally and survived) whereas it seems all of the nitrobenzodiazepines are toxic. I'm guessing it's the body reducing it (I know, the body is usually an oxidative instrument but aromatic nitro groups are an exception).

 

[emkee_reinvented]

Clomethiazole is still out there. ....

It's interesting that clobazam seems to be used by more and more nations each year. I don't know why after 50 years it would still be of interest. I SUSPECT it's because the alternative, clonazepam, isn't well tolerated by many people and is often used in intentional overdoses (suicides). As you may know, people have survived multiple grams of diazepam (I've read of a case in which someone took 4 grams orally and survived) whereas it seems all of the nitrobenzodiazepines are toxic. I'm guessing it's the body reducing it (I know, the body is usually an oxidative instrument but aromatic nitro groups are an exception).

My 1998 copy of the drug bible (farmacotherapeutisch kompas) still has Clomethiazole in it, as anti-convulsant. Lucky whoever got them. Then again so were Meprobamate and Dextomoramide in it and al have been removed since.

Clobazam, according to the same bible (the updated version), as well as Clonazepam are add-ons for Epileptics. Some dr's prefer the one others the other I guess. Clobazam is kinda unique in its effect as it isn't very sedating but a much better anti-convulsant and anxiolytic vs Clonazapam. Which I have barely no experiece with. Somehow it reminds me a bit of Pyrazolam.

 

[Fertile]

Like pyrazolam, most of it's activity is at different sites to most benzos. For pyrazolam it was a1b2 & a1b3 while with clobazam it's a2b1 & a2b2 so I guess they will be similar.

I have read of only 1 death in which pyrazolam MAY be associated. In Fiinland a man was found next to bags labelled 'pyrazolam', 'diclazepam', '3-F phenmetrazine', '1-(2-fluorophenyl) propan-2-amine' and an empty box of diphenhydramine.

I think the body was too decomposed for proper toxicology (to give plasma levels of each drug) but it's a crazy mixture - uppers & downers mixed.

 

[ChemicallyEnhanced]

I find the fact that doctors will prescribe things like Quetiapine or Olanzapine as "safer" alternatives to benzo's is both hilarious and terrifying.
I'll take being temporarily dependant on a benzo and being tapered off over permeant Tardive Dyskinesia any day.

 

[AlphaMethylPhenyl]

I think that those ones aren't known for EPS, but some antipsychotics are.