Benzodiazepines

I’ve suffered from insomnia for the last two and a half  years. About two of those years I was reliant on, and addicted to, sleeping pills – a particularly nasty one among the mix (tried many, but three different ones seemed to work).

I unintentionally became physically dependent on a benziodiazepine called lorazipam – the trade-name is Ativan – and weaning off the drug took me over a year, and several tries (coincidentally, this is such a huge problem that there are private ativan treatment centers all over the USA – and I assume all over the world).

The cost/benefit analysis I went through – where the benefit of the drug is likely outweighed by it’s personal cost – is experienced by most benzodiazepine users. I’d like to make sure you’re aware of this cost before you start down the road of benzodiazepine prescriptions.

Lorazepam (or Ativan) is just one of many different formulations of benzodiazepine. The other “Benzo” names (it’s such a common drug, with such common use and common dependency issues that it has a nickname) you might be familiar with (again, with some help from Wikipedia) are:

Drug Name	Common Brand Names
Alprazolam	Helex, Xanax, Xanor, Onax, Alprox, Restyl, Tafil, Paxal
Bretazenil	N/A
Bromazepam	Lectopam, Lexotanil, Lexotan, Bromam
Brotizolam	Lendormin, Dormex, Sintonal, Noctilan
Chlordiazepoxide	Librium, Risolid, Elenium
Cinolazepam	Gerodorm
Clonazepam	Rivotril, Klonopin, Iktorivil, Paxam
Clorazepate	Tranxene, Tranxilium
Clotiazepam	Veratran, Clozan, Rize
Cloxazolam	Sepazon, Olcadil
Delorazepam	Dadumir
Diazepam	Antenex, Apaurin, Apzepam, Apozepam, Hexalid, Pax, Stesolid, Stedon, Valium, Vival, Valaxona
Estazolam	ProSom
Etizolam	Etilaam, Pasaden, Depas
Flunitrazepam	Rohypnol, Fluscand, Flunipam, Ronal, Rohydorm,
Flurazepam	Dalmadorm, Dalmane
Flutoprazepam	Restas
Halazepam	Paxipam
Ketazolam	Anxon
Loprazolam	Dormonoct
Lorazepam	Ativan, Temesta, Tavor, Lorabenz
Lormetazepam	Loramet, Noctamid, Pronoctan
Medazepam	Nobrium
Midazolam	Dormicum, Versed, Hypnovel, Dormonid
Nimetazepam	Erimin
Nitrazepam	Mogadon, Alodorm, Pacisyn, Dumolid, Nitrazadon
Nordazepam	Madar, Stilny
Oxazepam	Seresta, Serax, Serenid, Serepax, Sobril, Oxabenz, Oxapax
Phenazepam	Phenazepam
Pinazepam	Domar
Prazepam	Lysanxia, Centrax
Premazepam	N/A
Quazepam	Doral
Temazepam	Restoril, Normison, Euhypnos, Temaze, Tenox
Tetrazepam	Mylostan
Triazolam	Halcion, Rilamir

There’s probably several drugs on this list that are familiar to you…

In addition to it’s status as a prescription drug, it’s also got a big black market for their use recreationally.

When Benzos were first introduced onto the market in the 1960′s they were seen as a huge breakthrough – found to be much less dangerous than their predecessor – barbituates. All the benzo’s in the list are from the same family, and they all act basically the same way. The major difference (obvious to me) is their active concentrations and their different half life.

To see what their potency and half-lives are (an important thing to know when you want to wean off the drug), go to this Wikipedia link.

What Benzodiazepines Are Used For

Benzos are used for a number of things, and not being a doctor I’m only familiar with their use for sleep. They’re available in a variety of “half lives” – the shorter half-lives are for insomnia, and the longer ones are generally for:

• Seizures
• Anxiety (often given to patients before surgery or an MRI)
• Panic attacks or panic disorder
• Alcohol withdrawal

You’ll note that they’re all, more or less, a way to manage some kind of anxiety. Benzos act in your brain as a GABA enhancer (GABA is neurotransmitter), and the calming, sedative affect they have is also used to aid sleep… in the short term.

If you’re prescribed Benzos for anything other than sleep (or even if it is for sleep), I’d suggest you research them completely, and ask your doctor lots of questions.

The Side Effects of Benzodiazepine Use For Sleep

I was cautioned about this before starting with lorazepam, but (having never taken them before) I decided that my sleep was far more important than some dependency in the future.

• Periodically – every few weeks for a night or two – they work.
• Short term – under a month – they work. They work well.
• Long term – over a month – they have a paradoxical effect. It not only takes more and more of the drug to get the same benefit, but when you find it’s time to leave the drug behind – you can’t.

There are many warnings about trying to quit Benzos cold-turkey once you’ve got that physical dependency (after a few weeks of continuous use). It can cause seizures that could lead to death, schizophrenia, or suicide. Very nasty stuff.

You have to wean off the drug very slowly – normally taking several months. This has become such an issue that there is even a support group for it.

As if that weren’t enough (the long wean), it can cause an effect called “rebound insomnia”. This is where the lack of the drug (ie: weaning) actually causes insomnia worse than the initial reason you started taking it.

But if you persevere, you will get through it. Having a doctor that’s willing to “play ball” with you helps immensely. I’d say if you don’t have one willing to help, find another. You shouldn’t have to do this on your own.

As I said up top, it took me over a year to wean off the Ativan, and now when I occasionally take it (one night every couple of months), I find it does nothing… or does it?

My Personal Benzo Experiment

Benzodiazepines may work well to help you sleep – but the sleep that you get might not be that refreshing. And you’d never really know unless you had a tool to help you look (I happen to have a Zeo).

Benzos are known to suppress deep sleep. One night I thought I’d take 1mg of lorazepam (Ativan) to see what it does, and if I could measure it. I could.

Notice the very short deep sleep – about half of what I’d normally get. It also occurs later in the night than I would normally experience.

So the question becomes “even if Benzos help you sleep, is it the kind of sleep that you want?” REM and Deep Sleep are important, and if you’re not getting enough deep sleep because the drugs are suppressing it, then why bother?

The Sleeping Pill Conundrum

After some experience with several kinds of pills, I now believe they all offer an empty promise. Either you get the long-term affects of benzodiazepines, or the next-day hangover of many of the others. There’s no panacea.

They all lose effectiveness after a few weeks.

So my advice would be – take them one night if they help you sleep. And don’t take them again for several more nights. You’d be surprised just how much we do sleep even when we think we don’t.

Go and look into some basic sleep hygiene. Start there, and your sleep will probably improve without the need for any more drugs….

**PS: Just read this one this morning: Ambien and Restoril have been linked to a higher death risk! They’re both short-acting benzodiazepines. Get off benzos now!

*PPS: Now they’re not even sure that sleeping pills work at all! Seems there might be a “anterograde amnesia” going on here – where we actually wake up, but forget that we were awake! See the research!