BENZODIAZEPINES
Ben - zo - dye - ay - ze - peens
Why have I been prescribed a benzodiazepine?
The usual reason is to relieve the symptoms of anxiety and insomnia.
Being tense or feeling worried is common to all of us. For example, going to the dentist or starting a new job can be
stressful, but sometimes you can feel anxious or worked up for no apparent reason at all, or it is out of proportion with the
stress. This is an illness called anxiety. It can come on suddenly or it may be there all the time. Anxiety has many
symptoms. You may find you cannot relax easily. The muscles in your face and neck may ache. You may even sweat
more than usual and look pale. Sometimes you may have attacks of severe anxiety or panic. Your heart may beat faster
and this can worry you even more. Anxiety can get so bad that it makes your life very unpleasant indeed. You may be
less able to cope with stress.
People with anxiety may also have problems with their sleep. You may find it hard to fall asleep or stay asleep. This is
called insomnia. There are many causes of insomnia. Some medicines, even those from your pharmacist, can cause it.
The benzodiazepines can help people with anxiety or insomnia. Benzodiazepines are also useful to help manage alcohol
withdrawal, agitation, epilepsy, hypomania, panic disorder and some other conditions.
What exactly are benzodiazepines?
Benzodiazepines are also called anxiolytics (or, incorrectly, as minor tranquillisers) and hypnotics or sleeping tablets. This
means that they can calm people down and help them to relax or sleep. Some benzodiazepines have been around for
more than thirty years and millions of people have now taken them. Benzodiazepines are not a cure for your anxiety or
insomnia. They only help with the symptoms.
There are many benzodiazepines, some usually used for anxiety and others as hypnotics (or sleeping tablets). The first
group includes diazepam (‘Valium’), chlordiazepoxide (‘Librium’), lorazepam (‘Ativan’), alprazolam (‘Xanax’), bromazepam
(‘Lexotan’), chlorazepate dipotassium (‘Tranxene’) and oxazepam. The second group includes temazepam, flurazepam
(‘Dalmane’), loprazolam, lormetazepam, flunitrazepam (‘Rohypnol’) and nitrazepam (‘Mogadon’, ‘Remnos’).
Are the benzodiazepines safe to take?
It is usually safe to have benzodiazepines regularly for a short time as prescribed by your doctor, but they don’t suit
everyone. Let your doctor know if any of the following apply to you, as extra care may be needed:
a) if you have depression, breathing problems, myasthenia gravis, porphyria, or suffer from liver, or kidney trouble;
b) if you are taking any other medication. This includes medicine from your pharmacist, such as cimetidine (‘Tagamet’),
chlorpheniramine (‘Piriton’) or Phenergan;
c) if you are pregnant, breast feeding, or wish to become pregnant.
How should I take my benzodiazepine?
Look at your medicine bottle - it has your doctor's instructions on it. Follow these directions very carefully. Always take
your dose with a full glass of water. Never be tempted to change the dose yourself. If you forget a dose, take the next one
as soon as you remember, as long as it is only a few hours after the usual time.
What should I do if I miss a dose?
Never change your dose without checking with your doctor. If you forget a dose, take it as soon as you remember, as
long as it is within a few hours of the usual time.
What will happen to me when I start taking my benzodiazepine?
Some benzodiazepines can work after only half an hour or so. If taken at night, you should be able to get to sleep more
easily. Sometimes, you may feel a bit drowsy or groggy in the morning. When taken during the daytime, you should feel
more calm and relaxed.
Like all medicines, the benzodiazepines have some side effects. Most of these side effects are quite mild and should go
away after a week or so. Look at the table over the page. It tells you what to do if you get any side effects. Not everyone
will get the side effects shown. There are many other possible side effects. Ask your pharmacist, doctor or nurse if you
are worried about anything else that you think might be a side effect.
Side effect What is it? What should I do if it happens to me?
COMMON
ATAXIA Being very unsteady on your feet. Discuss with your doctor when you next see him/her.
DIZZINESS Feeling light-headed and faint. Don't stand up too quickly. Try and lie down when you
feel it coming on. Don't drive.
DROWSINESS Feeling sleepy or sluggish. It can last for a few
hours after taking your dose.
Don't drive or use machinery. Ask your doctor if you
can take your benzodiazepine at a different time.
RARE
AGGRESSION Feeling excitable. You may be talkative or
unfriendly.
Discuss with your doctor. He or she may want to
change your dose.
AMNESIA Loss of memory or difficulty in remembering. It is not dangerous. Discuss with your doctor if you are
worried.
CONFUSION Your mind is all mixed up. Discuss with your doctor when you next see him/her.
HEADACHE When your head is pounding and painful. It should be safe to take aspirin or paracetamol.
HYPOTENSION A low blood pressure. You may feel faint when
you stand up.
Try not to stand up too quickly. If you feel dizzy, don’t
drive. This dizziness is not dangerous
RASHES Blotches seen anywhere. Stop taking it and see your doctor now.
What about alcohol?
It is officially recommended that people taking benzodiazepines should not drink alcohol. This is because both
benzodiazepines and alcohol can cause drowsiness. If the two are taken at the same time, severe drowsiness can result.
This can lead to falls or accidents. Once people are used to taking benzodiazepines, they can sometimes drink alcohol in
small amounts without any harm. Avoid alcohol altogether for the first one or two months. After this, if you want a drink,
try a glass of your normal drink and see how you feel. If this doesn’t make you feel drowsy, then it is probably OK to drink
small amounts. It pays to be very cautious because alcohol affects people in different ways, especially when they are
taking medication.
Don't stop taking your medication because you fancy a drink. Discuss any concerns you may have with your doctor,
pharmacist or nurse. If you do drink alcohol, drink only small amounts. Never drink any alcohol and drive.
Are the benzodiazepines addictive?
If you take a benzodiazepine every day for more than about two to four weeks, you may then get some withdrawal effects
if you then stop them suddenly. These may be like your original symptoms of anxiety but may be worse. Dependence
does not happen if you take benzodiazepines every now and again, or only for a few weeks. Try and take them only when
you think you need to. Discuss with your doctor when and how you should stop taking them.
Can I do anything else to help myself?
Yes. Many people join a self-help group. Listening to others who have had similar problems can often help. There are
many books on anxiety and insomnia - ask your doctor. Relaxation and breathing exercises can usually help relieve
tension. Ask your doctor, pharmacist or nurse for advice.
Remember, leaflets like this can only describe some of the effects of medication. You may also
find other books or leaflets useful. If you have access to the internet you may find a lot of
information there as well, but be careful, as internet based information is not always accurate.
2001 United Kingdom Psychiatric Pharmacy Group www.ukppg.org.uk
This leaflet is to help you understand about your medicine. It is not an official manufacturer's Patient Information
Leaflet. For more information call the UKPPG National Telephone Helpline, 11am to 5pm, Monday to Friday
on 020 7919 2999 or visit www.nmhct.nhs.uk/pharmacy
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