Are you facing sustained anxiety and being prescribed a benzodiazepine? Have you heard of the hazards of the long term use of benzodiazepines? If not yet, then go through the article “Long Term Benzodiazepine Use for Anxiety”.
In this article, I have tried to collect all the information regarding the long term use of benzodiazepines for anxiety, the best benzos for long term use, and the best alternatives to benzos. I have also gone through drastic psychological and physical effects on the body due to benzodiazepines.
Moreover, I have not forgotten the older elders of our society, to whom long term use of benzodiazepines can be severe. So, let us start our most informative article.
Long Term Benzodiazepine Use for Anxiety
Benzodiazepines includes flurazepam, brotizolam, flunitrazepam, midazolam, loprazolam, lormetazepam, triazolam, nitrazepam, temazepam, tetrazepam, bromazepam, alprazolam, diazepam, lorazepam, chlordiazepoxide, oxazepam, clobazam, medazepam, and prazepam.
The long term use of benzos can have devastating physical and psychological effects. However, these effects may normalize later after withdrawal of benzos. In some cases, the effects are long-lasting and even permanent.
The long term use of benzodiazepines can be acceptable when the symptomatic relief is much greater than the fear of dependency on them.
There are certain restrictions regarding Benzo’s intake. You should avoid alcohol during long term benzodiazepine treatment. It can make you sleep deeply. Thereby causing difficult wake-up or even breathing problems.
Do not use tools or machines and do not drive after taking benzos, you can feel sleepy, and may hurt yourself.
Tell your doctor your medical history first, before going for benzodiazepines. If you have depression, sleep apnea, personality disorders, and suicidal thoughts, then it is better to avoid benzodiazepines.
Conditions like atherosclerosis, kidney or liver disorders, trying to get pregnant, already pregnant, or breastfeeding, and myasthenia gravis may worsen by intaking benzos. Better to tell your doctor, before the long term benzodiazepine prescription.
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Which Benzo Is Best for Long Term Use?
Diazepam and clorazepate are the most preferred benzodiazepines, for long term use. Both are the least addictive benzodiazepines. Both are the best benzos to treat sustained anxiety. Their long term use is justified only in chronic anxiety patients, in which curing of symptoms and improved functioning of the body has exceeded the dependency risk factor on benzos.
Can You Take Diazepam Long Term for Anxiety?
Yes, you can take diazepam long term for anxiety. But it is preferred only in cases when sufferings from anxiety have exceeded the risk of benzos dependency.
Diazepam can be used to treat fits and muscle spasm other than anxiety. It can also be taken before operation or other treatments for relaxation.
It is recommended, not to use diazepam for greater than 4 weeks. However, you should take it, according to your doctor’s prescription.
However, like every medicine, diazepam also has some side effects, that may occur in 1 in 100 persons.
The common side effects include loss of coordination, drowsiness, confusion, and tremors. But I repeat, the side effects are rarely experienced.
If you are experiencing serious side effects like hallucinations, amnesia, delusions, the white of your eyes or skin get yellow, or you are falling again and again, then you must consult your doctor.
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Are Benzos Safe Long Term?
No, benzos are not safe for long term use. Diazepam and clorazepate, also belong to the class of benzodiazepines. They are the least addictive benzodiazepines. They can be taken for long term use, but with certain limitations.
Some common side effects may occur, as mentioned in the first section. But, you should rush to your doctor if the situation will worsen.
Alcohol consumption should be avoided along with Benzos. Pregnant, trying to get pregnant, and breastfeeding women should avoid benzos.
Long Term Benzodiazepine Use in Older Adults
According to an analysis, older adults have a common tendency towards long term benzodiazepine use for anxiety.
The tendency towards long term use of benzos is greater in older adults with age greater than 80 years. The patients are found to be suffering from sleep disorders, dementia, and depression.
In older adults, long term use of benzodiazepine can cause a reduction in cognitive impairment. However, gradual withdrawal of dose can improve intellect.
Long term use of benzos in older adults can be toxic. Benzodiazepines in combination with cholinergic system-affecting drugs, and antihypertensives are the major cause of dementia in 10 % of the older adult patients, who were attending memory clinics.
The extensive use of benzos can induce pharmacological syndrome in elderly persons. The symptoms of such syndrome include weakness, drowsiness, ataxia, dizziness, fatigue, vertigo, confusion, and syncope.
The other sufferings associated with the pharmacological syndrome include cognitive impairment, visual and auditory hallucinations, sleepwalking, hypertension, aggressivity, insomnia, depersonalization, orthostatic, depersonalization, psychomotor, and sexual disorders.
Long term intake of benzodiazepines can also induce changes in the immune system. Reduction in neurotransmitters and cortisol levels and other biological indicators can appear.
A study has shown that elderly persons, who have gone through long term benzodiazepine use for anxiety, may get post-operative confusions.
Such elders have a greater tendency to get into fatal accidents. Discontinuation of benzos in older adults can normalize cognitive impairment and dementia.
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Alternatives to Benzodiazepines for Anxiety
In some people, anxiety becomes so unbearable that it can cause severe debility. You can go for proper mediation.
Benzodiazepine and other benzos are agonists and are found to be a cure to anxiety. However, long term benzodiazepine treatment is harmful.
So, you can go for other alternatives to benzodiazepines for anxiety. Sedative drugs and antidepressants can be used to treat anxiety.
Antidepressants are a good option to treat anxiety and panic disorders. Zoloft belongs to the SSRIs class drug. They have a lesser dependency risk than benzos.
Zoloft bears a major drawback. It takes about a week to start influencing and they must be taken regularly to continue its effectiveness.
The person who is prescribed an SSRI should use an alternative method, to manage anxiety and panic attacks, during the first week of consumption of Zoloft.
The treatment of anxiety with sedative drugs is also effective. Ramelteon and antihistamines can be used as sedative drugs. For long term medications, it is better to prescribe benzos alternatives for anxiety.
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What Is the Most Serious Risk Associated with The Use of Benzodiazepine?
The long term use of benzodiazepine (about three months) with an average consumption of about 17 mg per day, can cause a severe reduction in intellect. This decrease in intellect cannot retrieve even after removing the dose.
The excessive use of benzodiazepine can cause acute damage. They may induce sleepiness and lethargy. They can cruelly cause ataxia, drowsiness, anterograde amnesia, incoordination of motor neurons, and enhanced response time.
The motor vehicle crash risk is increased after the intake of benzodiazepine. Such a person is vulnerable to vehicle accidents, same as the one with alcohol consumption of about 0.050 to 0.79 %.
The intake of benzodiazepine can increase the risk of hip fracture, in aged people. The hip fracture risk is a maximum of 50 % in older adults with long term benzodiazepine prescriptions. According to research, the fracture risk is 2.55 times in people who are over 65 years.
Though benzodiazepine was the most prescribed agonist in the United States in the year 2009, its side effects regarding long term use cannot be overlooked.
The intake of benzodiazepine along with sedative drugs like alcohol and opioids can largely enhance its drastic effects.
So, it is not good to continue its dose for a period longer than a month. You can go for other effective alternatives like antidepressants and psychotherapy.
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Long Term Effects of Benzodiazepines on The Body
In 2015, research carried out by Finnish researchers has shown that about 3 % of the population is consuming benzodiazepines for more than six months.
A review in the same year has declared that a huge population of Germany is dependent on benzodiazepines.
However, long term benzodiazepines used for anxiety can have drastic effects on the body. The long term use of benzos can cause immunological disorders.
Higher doses of diazepam can induce greater pneumonia risk factors. This fact is based on a study carried out on people with tetanus.
These changes can in turn cause behavioral disturbances and reduced functioning of the immune system.
Long term use of benzodiazepines can cause reduced clinical benefits. It can lead to alcoholism and drug abuse.
A 2017 study has shown that benzodiazepine dependence can cause an enhanced risk to develop cancer.
Fifteen epidemiologic studies have shown that benzodiazepine use is associated with an increased rate of mortality, especially cancer-related deaths.
The cancer types include neoplasm, breast, bladder, bowel, brain, and lungs. It has been assumed that benzos lower immunity, thereby increasing viral infections and could further induce cancer.
It has been a controversy that use of benzos during pregnancy can have neurodevelopmental disorders. Such babies have a lower weight at birth. However, at an early age, they can catch up to normal babies.
Other clinical symptoms of benzos intake during pregnancy include craniofacial anomalies, impeding the development of pincer grasp, aberrations in muscle tone, and patterns of movements. So, long term use of benzodiazepines can induce adverse effects on the body.
What Are Physiological Effects of Benzodiazepine Use?
The long term use of benzodiazepines can cause cognitive impairment. It includes decreased memory, sustained attention, visuomotor, psychomotor, verbal learning, and visual-conceptual abilities.
Short-term changes occur in the brain of people, who have gone through the long term use of benzodiazepines, which have been found by using neuroimaging. However, no abnormalities have been found.
However, the reduced intellect due to long term use of benzodiazepines, can improve in the first six months of withdrawal and may return to the baseline, if not permanent.
The dependency or better to say addiction to benzodiazepines can have severe effects on sleep architecture.
In the short term use, benzodiazepines can treat insomnia, but in the long term, they can worsen the situation.
It may cause decreased sleeping hours, delayed and reduced REM sleep, enhanced beta, and alpha activity. It also includes reduced K complexes and delta activity and deep slow-wave sleep.
The disturbance of sleep architecture can in turn cause psychiatric symptoms like psychosis, irritability, and mood.
People with long term benzodiazepine prescriptions are at greater risk to develop psychotic symptomologies like hallucinations and delusions.
A study has shown that one-third of the users of the benzodiazepine drug i.e., Xanax have developed depression.
Long term use of benzos can cause a remarkable risk of suicide thereby increasing the mortality rate. Patients with long term use of benzos were found to develop irritable bowel syndrome, agoraphobia, paraesthesia, and enhanced anxiety and panic attacks.
The long term use of benzodiazepines can cause depersonalization and perceptual disturbances in some individuals.
Excessive users of benzodiazepines can become vulnerable to blepharospasm. It depicts that the effects of long term benzodiazepine use for anxiety are just like other hypnotic sedative drugs like barbiturates and alcohols.
The benzodiazepine-exposed babies are found to have lower head circumference, functional deficits, mental retardation, lower intelligence, and long-lasting behavioral abnormalities. So, long-term benzodiazepine prescription can have devastating psychological effects.
Concluding my article, “Long Term Benzodiazepine Use for Anxiety”. I would only suggest that there are several severe side effects of long-term benzodiazepine use for anxiety. However, diazepam is the least addictive benzodiazepine.
You should only go for long-term benzos intake if the relief from anxiety has overtaken the addiction risk. Do not forget to go through the restrictions (mentioned in the first section), in which you should completely avoid benzodiazepine’s use.